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How I got my sleeve approved.



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I have RightChoice in Missouri. I am semi lucky in the fact that my company is self insured, so all of my appeals eventually went to the higher-ups within my company. What almost cost me the procedure, though, was the fact that I have NEVER done Jenny Craig, WW, etc. The only "measure of failure" I had was to approach my PCP and have her write a letter stating that she had been my PCP for over 10 years and that we had discussed WL on numbers of times.

Insurance even initially balked at that because they wanted documented discussions of weight and, lucky me (not), my PCP had recently converted over to a completely electronic filing system and only had her "important" notes going back more than 2 years. I just kept documenting and researching and killing my insurance company with paper, and it eventually worked.

I guess what I am saying is that from start to finish it was well over a year of fighting with them, but I am SO glad I did. This is not a sprint, so I feel like all of the work to get the procedure has made my determination to make it work even stronger.

Keep up the fight if you are still fighting, and if you want copies of the letters I sent, I am more than happy to send them to you. Every little bit helps.

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I have RightChoice in Missouri. I am semi lucky in the fact that my company is self insured, so all of my appeals eventually went to the higher-ups within my company. What almost cost me the procedure, though, was the fact that I have NEVER done Jenny Craig, WW, etc. The only "measure of failure" I had was to approach my PCP and have her write a letter stating that she had been my PCP for over 10 years and that we had discussed WL on numbers of times.

Insurance even initially balked at that because they wanted documented discussions of weight and, lucky me (not), my PCP had recently converted over to a completely electronic filing system and only had her "important" notes going back more than 2 years. I just kept documenting and researching and killing my insurance company with paper, and it eventually worked.

I guess what I am saying is that from start to finish it was well over a year of fighting with them, but I am SO glad I did. This is not a sprint, so I feel like all of the work to get the procedure has made my determination to make it work even stronger.

Keep up the fight if you are still fighting, and if you want copies of the letters I sent, I am more than happy to send them to you. Every little bit helps.

Thanks for this post! If I do need anything I will let you know.

Congrats and best of luck to you. :)

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