Question:
I WAS DENIED BY MY INS BECAUSE OF DIET HISTORY
DOES ANYONE HAVE AN APPEAL LETTER THAT WAS APPROVED OR ANY IDEA HOW TO SCRIPT A GOOD LETTER. I AM SO SCARED TO GET DENIED AGAIN. — barbara M. (posted on December 11, 2003)
December 11, 2003
we need some more info to answer your question. were you denied because you
didn't haev enough diet history or you didn't have any at all?
— franbvan
December 11, 2003
I read your profile and I have to sadly tell you that I've not heard of
anyone yet who's managed to get around the 6 months supervised diet. Some
have been able to get them to accept clinical supervision (Jenny Craig, for
example), but you really need to be able to show them a supervised attempt.
Good luck!
— [Deactivated Member]
December 11, 2003
I would say that if your problem is not having enough diet history that the
sooner you go to a doctor, get put on diet meds and get a diet, the better.
Their purpose in doing this is to show that you have attempted weight loss
on your own with no success. Any time you might have been on meds like
Redux, Fen-Phen, Xenical, Meridia, etc. would show as diet history because
you have to see your doctor to get the prescriptions. We need more
information to answer you specifically.
— Diana M.
December 12, 2003
Hi! I was denied by my insurance company (Aetna) also because I had no diet
history---I basically went to see my Doctor 1st a month for 5 months just
for him to take my weight and go over what I've been doing for weight
loss--I took a yoga and reduced my fat in take--that's it--I resubmitted my
paperwork to Aetna along with my doctor's notes on my visits and within
less than a week they approved me. I am schelduled to have surgery
Thursday. Good luck!!
P.S. I did also include a personal letter.
— marie A.
December 12, 2003
Hi, I have Cigna PPO and I was denied twice because of diet history.
Cigna goes through a company called Intracorp to handle their cases and
they wouldn't tell me exactly why I didn't qualify, only that the wording
in the THREE letters the doc sent was insufficient. Soooooo, I asked my
PCP to call Intracorp 1-800-280-7651 and ask to speak with a doctor on
their medical review board. My PCP called me back that afternoon and told
me I was approved. He said they just wanted to hear from him to verify the
info in the letters he sent. Cigna requires a 26 week medically supervised
weight loss attempt to qualify (which I had four times over) Also needed a
phsyc eval, nutritional eval too. Hope this info helps. Nicole
— boonikki29
December 12, 2003
I had the same problem with my insurance. I have GHI(Medical)/Empire Blue
Cross Blue Shield(Hospital) and BC/BS uses Intracorp to make the decision.
My medical insurance would pay the surgeon but BC/BS didn't want to pay the
hospital bill. I was denied b/c of the diet history. I hired Walter and
Kelley Lindstrom to appeal my case and 3 days after a letter of
representation was sent out I was approved. Their website is Obesitylaw.com
— Lisa N.
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