How to get approved and ruin your heart in the process

Laura K.
on 6/24/03 4:07 pm - Phoenix, AZ
I truly believe because I tried to take the easy way out and use phen /fen and meridia that was documented by my Physician's records I was approved. While everyone else is having a hard time getting approved because they used weigh****chers and the rest, I took the easy road after years of trying all the nutrisystems and all. That's the good news for getting an approval, the bad news is I ended up with two bad heart valves and an enlarged heart on one side from Phen/fen and now they have concerns over meridia. My heart will need to be fixed some day but it was my cardioligist who wrote the letter that got me the approval. His feeling was that until I got the weight down number one he did not want to risk heart surgery, and number two that getting the weight off would improve the function of my heart. A couple of hints, my old insurance was Cigna and they did not approve me, but new insurance BlueCross/Blue Sheild Pinal county did approve me after the right things were submitted, those things were that my cardioligist and my primary Physician even though they were approved Cigna , were also on the approved BC/BS list! That really helped. I applaud all you out there who have worked so hard at losing weight but can not get verification of it. It really is a catch twenty two. Don't give up...if one Physicians office can not get you approved, try another one who may have a better handle on getting approved with your insurance. Get an approved provider physician list from your insurance company and or human resourses dept. if you have one, and check to see that the surgeon you are submitting through is on the list. Get letters from your approved general MD and any other approved Doctor you see, cardio., bone Doc. etc. I wish for all of you the right to get the surgery if you choose to. You worked hard to get insurance and pay dearly for it. Keep trying if it is important to you.
cindy
on 6/25/03 1:50 am - Mesa, az
Laura, you did not say who your surgeon is. I have a Blood Clot on the lower left venticle of my heart, not from Phen/fen, but from an enlarged heart for other reasons. Insurance was not a problem for me, I have Tricare Prime (military), but I have been seeing a cardiologist for years. I had to get a surgey clearance from my cardiologist, and he was not a bit hesitatent, because as your cardiologist, he felt the weight stress off of my heart would outway the danger of the surgery. I did not have a choice in surgeon's, my insurance only has one surgeon in the whole state of Arizona and Nevada and that is Dr. Zahn. I was upset with that, but now I am very glad that I was sent his way. I have found out that before Dr. Zahn changed to WLS, he use to be a heart doctor, and my surgery is considered high risk because of my heart. With all the problems with your heart, you may want to find a surgeon that does high risk surgeries.
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