Good morning friends.

I'm writing to you from my desk at work. I get paid to do a lot of things at work, and this is one of them. Thankful for that. Anyhow... I'm on here because I have a lot of anxiety related to approval for surgery. I just kind of started this journey beginning of June. Monday is my 2nd month appointment of 7 required months of supervised diet and weight loss management. I am doing most of the pre work at my primary provider as I cannot afford the time and money to drive over an hour away each way to Indianapolis. I called my insurance company more than once to try to get some guidance and advice on approval for this process. All anyone can tell me is that it requires 7months of doctor's visits. Nothing else. This past time I called they said check out the Indiana Medicaid website and go by that requirements. I have Indiana HIP insurance. Its similar to Medicaid (I don't make a lot of money) except I do pay for this insurance. Its low price, but I do pay. I tried going on the website. Nothing was searchable.

The program that I am looking to go through is St. Vincent out of Carmel, Indiana. They have their own preferred team of providers they want us to see, but it is not a requirement. What I am curious to know is that, based on this information, what are my chances of getting approved? The Carmel office said their approval rate is in the 90 percentile. They wouldn't give a percent for approvals based out of using primary care for pre surgery care. I'm sweating bullets. I know I am doing what I can. Best choice for my situation. I just don't want it to be for not. Ya know?

I have the blank template that the Carmel office said to use. I copied it and have it ready to submit to my primary doctor. I have also transcribed my food journal onto a Microsoft excel spreadsheet and calculated calories and ounces each day down for them. I have to be referred to a dietitian (which I plan to do this Monday at my next visit) before I can meet with one of those. I just want success. I want the knowledge that what I am doing is good enough for insurance.

I weighed in at the initial seminar at 312. Weighed in tonight at work at 309. I am doing something right. I hope.

Thanks

Do you have a login for the HIP MHS portal? Try sending a message there to see what you can find out. Finding policies on websites is not usually an easy task, even for providers. They don't have their clinical guidelines online for providers currently so I couldn't find anything at all.

If you can't message them via the website call the number on your insurance card.

Congratulations on the weight loss so far!

I do have portal account. I will email through it. thanks. Last time I tried emailing them about anything, they said call them. When you select the ask a nurse section, it makes you choose a topic. bariatric is not a topic. only eating disorders is. so I felt at a loss about it. will try again.

Try both a nurse and maybe a general or prior authorization option. Don't give up! Keep trying until you get what you need.