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Anyone From Buffalo, Ny Out There?

Hi, to all WNY'ers!!! I, just know I'm not the only one out there, lol! I'm 6 days post op, overall, doing well!!! So, how's everyone else doing???

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Protein shakes will bind you. I add some benfiber every once in a while.

  • 2 weeks later...

Who here has Independent Health and is pre-op?

On top of the already bad news I got last couple weeks, now I get a letter from Synergy stating that IH "changed policy" and now they require a six month doctor supervised diet.... this news, after already starting the process back in JUNE.

If my labs had passed two weeks ago I would already be submitted and approved.

Anyone else get this notice?? Not happy :angry:

Who here has Independent Health and is pre-op? On top of the already bad news I got last couple weeks' date=' now I get a letter from Synergy stating that IH "changed policy" and now they require a six month doctor supervised diet.... this news, after already starting the process back in JUNE. If my labs had passed two weeks ago I would already be submitted and approved. Anyone else get this notice?? Not happy :angry:[/quote'] I do not have IH but my insurance has the same thing. How long have u been with synergy? Have u seen any other drs? I called my ins company and they said I can use visits to my nut and psy dr. You never know.

I have IH and that was required. However after I had gone 2 times already Missy told me that I could see if my MD would write a statement about how weight loss and ways of trying had been discussed for at least 6 mos worth. Mabye try that?

Did synergy tell you about the 6 mos before they submitted it to insurance? I just met with Dr. Caruana Thursday and nothing was mentioned. I have IH too.

I have IH. I'M not sure about the requirement but I was on weight watchers 6 months prior to my approval. They may have counted that. Good luck!

I have IH. I'M not sure about the requirement but I was on weight watchers 6 months prior to my approval. They may have counted that. Good luck!

From what I have seen they want to see that you have made an effort to lose weight prior to surgery. Most insurances now was proof to that instead of just your word. It's only going to get harder now.

  • Author

I have Community Blue. Even though there was documented proof of other weight loss attempts, I was required to lose @ least 5% of my tbw. That was 20 lbs.. They (insurance) definitely wanted to see how commited I was.

I have IH and that was required. However after I had gone 2 times already Missy told me that I could see if my MD would write a statement about how weight loss and ways of trying had been discussed for at least 6 mos worth. Mabye try that?

Did synergy tell you about the 6 mos before they submitted it to insurance? I just met with Dr. Caruana Thursday and nothing was mentioned. I have IH too.

Back in July, Synergy sent me a list of all Independent Health requirements. I fulfilled all of them as of last month (except for having to get my thyroid labs re-done). There was no mention of a six month program, at ANY of my visits to Synergy, even with Caruana. And I did ask because I read a lot that this might be required.

I get a letter this week from Synergy stating that IH had "new requirements" including a documented six month doctor supervised diet program and a new required blood test for H-Pylori (campylobacter) which is a stomach bacteria that can create peptic ulcers.

It seems to me from all the different responses here that either Synergy is dropping the ball as far as what exactly is required, OR that either them or IH is being very selective with each individual's prerequisites. Either way, it's annoying. Whats even more annoying is over the last month I've called Synergy twice on two occasions (regarding viably important issues about my personal situation), left messages (because you can never get anyone on the phone), AND emailed -- and not one call or response back yet. This is all not sitting well with me.

Now I've lost almost 4 months because I've been doing my own "program", not doctor supervised or whatever the hell they want. Maybe I can get my doc to somehow count this in, but all IH has to do is check medical records to see what date I started so if something doesn't jive with billed office visits or whatever, they'll give more flack for that.

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If you already started the process, completed the requirements, I don't see how IH "new policy" would apply to members midstream??? I think IH is pulling a fast one, @QueenCityGirl. SMH!

From what I have seen they want to see that you have made an effort to lose weight prior to surgery. Most insurances now was proof to that instead of just your word. It's only going to get harder now.

Why I tried weight watchers first because of the materials and log book they give you my proof.

Why I tried weight watchers first because of the materials and log book they give you my proof.
did you already have approval from IH? With my insurance you can't get approval until you meet all the criteria and then they give you approval. I wonder if this has changed because of the affordable care act. You should call IH talk to a rep there. Sorry this is happening. Xo
did you already have approval from IH? With my insurance you can't get approval until you meet all the criteria and then they give you approval. I wonder if this has changed because of the affordable care act. You should call IH talk to a rep there. Sorry this is happening. Xo

Actually no my surgeons office just wanted me to list what I have tried and kept my ww stuff handy. I have blue cross through the County insurance and my primary wrote a letter I have been overweight for over 5 years. I got approved within 1-2 weeks. I had no worries for I have co workers in my building who have had it done.

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