Question:
Denied because not enough physician records of dieting
Blue Care Network says I don't have enough evidence of "Medically supervised weight loss attempts" for 3 consecutive, recent years. How do I appeal that, when my doctor's notes don't show that we discussed my weight every time I was in to his office? I've tried every diet, but didn't call the doctor to report every time I went on a new diet, and didn't go in to his office to get weighed all the time. — Denise K. (posted on October 1, 2003)
October 1, 2003
can you ask the doctor for the weights that he does have? let him know what
is going on.
— franbvan
October 1, 2003
I had this same problem. How many years do you have? I have been fighting
appeals because of this forever! Don't give up. Did they ask for a
written letter of dieting? Because I could send you a copy of the letter
that worked for me.
— athome2much
October 1, 2003
Denise - I am in the same boat as you - I have blue cross blue shield and
just got the same letter - maybe we can work on this together. I am going
to talk to my primary to see if she can write a letter based on what she
knows but I also have no medically supervised diets - always did it on my
own - 2X I lost 100 lbs and gained it all back and now that I have
hypothyroidism - the weight is soooooo slow in coming off - its almost
impossible to lose. I am frustrated....
— Michele M.
October 1, 2003
This is very common among many of the insurance plans. To gain approval on
my insurance I had to do a 12-week physician supervised diet and then
submit results in an appeal. This was because I did not have one to submit
it the past calendar year. Go to your doctor and get started now. Most
insurance companies won't budge on this one. Then you can re-submit.
— Cathy S.
October 1, 2003
I had only documentation for one six month structured diet program. I
informed my PCP all the various attempts I had made previously (after the
fact) and my best guess at what my weight was at the time. The PCP then
wrote a letter that went with my original package to the insurance company.
In the letter, he highlighted the diet history. I believe this is how I
missed that bullet.
— rleffler
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