Hi Cindy;
Thanks for your reply! I had opened an appeal to my insurance company regarding the denial for the consult and my husband just spoke to my appeals rep and she said that the med grp should not be able to deny the consult on the basis of criteria for surgery. It's just a consult for an opinion about the surgery. She told me that she thinks it'll be overturned.
I have requested the Health Plans written criteria for the surgery so that I know what to expect and will do what they require.
How did you prove the 5 year history of obesity? Do you have to have been "morbidly obese" for the 5 years? I have only been 40 BMI for two years and was pregnant for 9 months of that time. Before that I was definately 35 BMI for the 3 years before that. I guess I'll have to get records, but I have changed insurances and doctors more than a few times, so that should be interesting. I also don't recall getting weighed on a regular basis in any of the doctors offices. I do have some Weight Watchers booklets from a couple of years,but they show only a few visits on each. Adding that might help, I'm not sure.
I am glad to hear that once the requirements are met that the surgery does get approved.
Thanks!
I really appreciate knowing that
__________________
Sandy
248/goal 140
|