Add as a Friend
Send Message
Member Card
Block Member
on October 24, 2007 6:52 pm
Well, I just got the news yesterday that they denied me again. I just finished the 6 month supervised diet that they said I had to do. I needed to lose 10% of my body weight and have documentation that I was seeing my PCP every month along with a dietition. I did everything they needed and more. I even lost over 10 lbs more than was requiered. Now they come back saying that there isn't proof that it is a medical necessity. What the heck?? I went through what their criteria was line by line to make sure nothing was overlooked. Nothing is stated about it having to be a medical necessity. I have a BMI of around 60 and high blood pressure. I have gone on a doctor and nutritionist supervised diet for 6 months in which time I lost 54 lbs. Aside from appearing half dead, I don't know what else they expect me to do. My PCP is furious since we followed their guidelines to the T. He was going to contact my cardiologist, and surgeon and they are going to make a call to the insurance company themselves to argue the denial. I don't know what to do. I guess I will wait to hear from my PCP and start preparing my second appeal. Sorry so long, but I was certain that I would get approved this time. I was hoping to have the surgery before the end of the year and now I don't know what is going to happen. 
1 comment | Click here to leave a comment.
I will take the final step in completing my 6 month supervised diet this afternoon when I go to see my PCP. I do a follow up with him after I see the nutritionist every month. I have lost a total of 54 lbs during these 6 months and am feeling very proud of myself. I am excited and nervous about what will happen next. I will keep you posted...
