3Rd Time Isnt A Charm!

[TracyC 32]

I just heard back from my doctors office.

They use the Lindstrom Obesity Advocacy to appeal insurance decisions. The email address is walter@obesitylaw.com. If you don't get the results you are looking for with your doctors office, perhaps an email to this office is worth the time. It won't cost you anything to ask questions. Like I said before, the office is in California so you may have to wait a few hours for a response depending on where you are.

It certainly can't hurt. I wish you good luck as you push forward.

[sharonk 23]

Thanks tracy...im going to gather up the documents from my drs office so i can see exactly what my insurance is seeing! My guess right now is the paperwork is the problem bu i will keep this info handy!

[mommykristie 59]

Reading your story seemed like a repeat of my own. I jumped through all of the hoops that my insurance company wanted. For 2011 and 2010, my BMI was 40. However in 2009, I had a 39 BMI. My insurance (BCBS) only accepts high blood pressure, sleep apenea or diabetes as comorbidities. So adfter the 6 months supervised diet, etc. I was denied. Then denied again. They even denied obesitylaw. However during this time, we calculated that if I finished my last 6 month diet at the end of January 2012, then it would be a new year and the 2009 weight would not be counted. So the whole time through appeals, I worked with my surgeon and my family physicians office to start a new 6 month diet. The only catch being, I couldn't lose "too much" weight or else i would drop to 39BMI and be denied again. After my last January weigh in, insurance approval in 3 days!! I had my lapband surgery last Thursday. Keep hanging in there!

[sharonk 23]

Oh wow, good for you for sticking with it. I just mailed a letter to the appeals and grievences dept with my insurance company and i included the same 6 month diet write up alomg with my own write up. Im sure they will disregard mine but i figured it was worth a try. I just hope it doesnt hurt my case...you never know with these people! I also will have one more shot at a peer on peer appeal once my band dr comes back from vacation which is in early april. He agreed to try it again since he nevwr even had the chamce to discuss my case in full. Im keeping my fingers crossed but im also not getting my hopes up.

[NWgirl 574]

Have you got your paperwork from the surgeon's office yet?

[sharonk 23]

I ended up only getting the 6 month write up because thats what insurance is currently denying it on.