FitGator

Hello to Everyone - I am amazed at the support you give your members. I have been researching for a place to come and ask questions and learn about this new life I am about to embarq in. This is the place.

Would like your help in understanding the process a bit more.

I have done all the Psych, Nutritionists, letter from PCP stating the medical necessity for the surgery and 3 visits with my Surgeon and another letter from him. I even have a "penciled in" date (8/22) for the surgery. The paperwork was submitted 10 days ago. I have Higmark/PPO Blue in PA.

Today, my doctors office called me to tell me that my file has to go to review in front of a medical director. It appears, I have not have 6 months of documented visits with my PCP in regards to the weight loss program. I asked the office admin if it would be helpful for me to call the insurance company directly. She said it would not help. Do you think it would help or just sit tight and wait?

After reading all your stories I am ready for this new chapter in my life to being.

Thanks for your guidance.

Mavisavis

Welcome to the board!! This is indeed the best place to be. I don't know for sure your answer as mine did not require that. But I look forward to all your questions and posts......this is an awesome, although sometimes challenging journey. Also, you can go up to search and key in any topic and find tons of old conversations on them. Sometimes that gets you really started on the info.

__________________
Marty

Success is not final, failure is not fatal: it is the courage to continue that counts--Winston Churchill

Lap RNY 9-7-05
Dr. Ben-Meir
Cleveland Center for Bariatric Surgery
235/135/135
pre/now/goal

LyndasRoom

Hi and welcome~ Even if you have to do the 6 month supervised diet, like most of us, it's worth the wait. Read, read, read...others' experience is a great teacher!

__________________
Lynda
July 11,2006
Dr. Callery
309/198/150
Century 6/1/2007
Onederland 8/26/2007

bloomer001

Hi, and Welcome! You did find the right place, it has been incrediable the help I have gotten here, you will love it! Everyone is friendly.

I have Highmark BC/BS in PA (Pittsburgh Area) and did have to have 6 months supervised diet. My PCP has been working with me and had no problem with providing that, but without it I don't know what they will do. Personally I would call. Before I even went to the surgeon I had called and spoke to someone and they started a 'case' for me with all the information I gave them. Then when the surgeon submitted all the paperwork, it only took them 4 days to approve it.

Good Luck
Jennifer