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6 or 7 months medically supervised diet?!



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Nyteacher125 I totally agree, you jump through all these hoops and they still might not approve you!

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Right, I guess I see every other group having a voice in the media etc... Even transgender people who comprise less than 1% of the population are being accommodated with the bathroom if they self identify... I have self identified I have a problem with weight and every doctor who has treated me identifies it too... Yet I'm left wondering if I'll be approved or denied treatment.

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Totally, and to boot the people who are approving and denying are people just like you and me no medical background what so ever.

(Well maybe your a dr. I'm not)

Edited by lasmith0802

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I'm a teacher, I haven't even been denied yet but have been working on the draft of my appeal letter... There is no medical research to support doing the six month diet.

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That's smart! When are you looking to submit your info the the insurance company?

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On May 25th, I'm meeting with the nut, psychologist and surgeon. My endocrinologist has faxed a letter over, which I hope will cover the 6 months things... In my mind I'm hoping it could be submitted the same day or with a few days of my appointment... I'm a teacher and ideally having the surgery over the Summer would be perfect.. This is the game plan but as they say you plan and God laughs so let's see how it turns out... By this time next week I'll know more.

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Edited by nyteacher125

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Working for an insurance company helps me a little with knowing medical policies and whatnot but we can only follow what the medical policy states. The doctor may be saying that insurance companies like to see 7 visits but have you spoken with your ins to find out? I have and work for Highmark bcbs, ours states 6 consecutive monthly visits with at least 3 weeks between each visit.

When I went to my surgeon, he wanted to consider that as my first weight check but since my surgeon is 1.5 hours away, he agreed to let me do then checks with my pcp who I went to see the next week.

I do know that authorizations can take as little as a day to as long as a monthly depending on if something is missing when the original authorization is submitted but it is not something that a customer service agent can control.

Good luck and I hope our months go by quickly!

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So did you only have to do 6 weighs in instead of 7 like the other people? I have empire bcbs.

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I have to do 6, started in March, I've had one March, April, May, then I'll have June July and August and be able I schedule for an August surgery.

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Working for an insurance company helps me a little with knowing medical policies and whatnot but we can only follow what the medical policy states. The doctor may be saying that insurance companies like to see 7 visits but have you spoken with your ins to find out? I have and work for Highmark bcbs, ours states 6 consecutive monthly visits with at least 3 weeks between each visit.

When I went to my surgeon, he wanted to consider that as my first weight check but since my surgeon is 1.5 hours away, he agreed to let me do then checks with my pcp who I went to see the next week.

I do know that authorizations can take as little as a day to as long as a monthly depending on if something is missing when the original authorization is submitted but it is not something that a customer service agent can control.

Good luck and I hope our months go by quickly!

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So did you only have to do 6 weighs in instead of 7 like the other people? I have empire bcbs.

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I have to do 6, started in March, I've had one March, April, May, then I'll have June July and August and be able I schedule for an August surgery.

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Thank you lots! I started in January so I'm hoping for July but my surgeon doesn't schedule till approval.

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@@Donna415 I was thinking of calling my insurance and asking again. I'm not sure why they said that. Maybe they misunderstood what I was saying. I called my surgeons office today, I'm waiting on a call back. Hopefully it dose only take a day for approval:) and hopefully the lady at my surgeons office was wrong

Sometimes it can take longer and all policies are different but I know with bcbs WV and bcbs pa, it's 6 consecutive monthly visits within 2 years prior to surgery. I cross my fingers and toes for you that it's a short time to approve!!

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So I talked to my surgeons office today and the lady who schedules the surgeries told me that they had been submitting to the ins company's after six consecutive weigh in... But most patients were getting denied because you have to finish the sixth month with a last weigh in. So June 14th is my official last medically supervised weigh in. Then they can submit my paperwork to the insurance....

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@, my last app is the 25th also! It's at 9am! It's almost here woohoo!!

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Lucky you!!! That will be my first appointment but I'm crossing my fingers my documentation from the endocrinologist will cover the six month of non surgical weight management. If so, sleeve here I come!!!

It has taken a bit to find a surgeon I like, the first two just weren't my cup of tea. From meeting this one at the seminar I just loved his attitude and understanding of the struggle of obese people

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Edited by nyteacher125

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Monday I finish up my 4th month (my 5th appt with DR)! it has gone by real fast! Getting pumped up and ready for surgery!

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I just got an email from my insurance coordinator that the first weigh in counts and one month just letting you guys know! Everyone's insurance is different I guess.

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Had my final weight in today, down another 4lbs. For a total of 30lbs. Now comes the waiting find out what the insurance company will say. I have jumped through all the hoops and filled out all the paper work. Fingers crossed [emoji1317]

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