This last month-month and a half

z_m14
on 5/25/16 9:16 pm
RNY on 07/05/16

My anxiety is starting to well up within me. I'm just really excited for this pre-op six-month hell to be over! 

I called my bariatric center, and they said I should call them when I finish my final PCP visit so that they can send my paperwork to Highmark. I have read on this site that some people have been denied because their PCP wasn't thorough in his or her notes. I guess the evaluator(s) are looking for specifics in regards to my six-month program. Is there anything I should tell my PCP? I'm sure he knows what to do, but I just want to minimize the possible headaches. I'm thinking of printing out a copy of the medical policy and giving it to him so that he can be sure to include everything they want. 

How long did it take you to hear from your insurance company? I am really hoping the wait isn't too long because I want to get this surgery in time so that I can go back to school in the fall. I'm really hoping this waiting is worth it! 

 

 

Darcy G.
on 5/26/16 12:23 am
VSG on 04/07/16

I'd definitely bring a print out! It's easy to forget sime things later during the report writing.

I'd put Weight History on top of the list, at least one weight per year with special inclusion of spells wen you did lose some, then if it came back, and how much--since many f us diet our ways to progressively higher weights.

I don't remember iif you've got comorbidities, but I'd ask him to Mae note of weight-related health issues, and then focus on the ones that will be improved with weight loss. Sleep apnea, GERD, hypertension, joint issues, cardiac issues, menstrual/fertility issues... Anything and everything. Medicines and future tests that could be avoided after weight loss does pay off for insurance companies!

The rest I'd expect your center to have, but(and this is just my opinion) I lay more weight on the PCP's recc since the center has financial reasons to pull for the surgery, but your PC just has your well-being in mind. Nothing to gain. So if he/she can write a compelling report for you, it can only help!

Good luck and fix it in your mind right now that you're going to fight it if they deny, while hoping they're sensibly so  it doesn't come to you needing to break out the angry face :)

Program Start Weight 346 | Surgery Weight 282 | CW 217 | 5'-6.3"

High Weight 376, about a year before program. I gave up diet pop(and all pop), dropped 30 pounds without trying, and kept it off. Now convinced Carbonated Beverages. Are. Evil.

DISCLAIMER: My posts often have weird typos... Because I use a tablet or Kindle to access the forums despite how much I suck at tablet typing. Apologies!

z_m14
on 5/26/16 5:42 am, edited 5/25/16 10:48 pm
RNY on 07/05/16

Good ideas. I may ask him to include my weights for the past four or five years. My BMI has always been over 40, but I did weigh 100 lbs. less four-five years ago when I did my own diet and exercise, but then I gained it back. I think it would be a good idea to include it. 

 

I don't have comorbidities (yet), but my BMI is around 63. I think I may have him include my morher's diabetes in the letter since it runs in the family. Whatever I can do!

(deactivated member)
on 5/26/16 4:23 am

I did not have ins so I can't comment on that but I would just like to say YES is is worth everything you are going through right now. Good luck.

Cindypraying
on 5/26/16 11:28 am

My Dr. Only wrote a note that she has seen me for a year for weight loss

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