So Frustrated!!!

Okay, I am currently almost at the end of the 1st month of my 6-month diet, and I am very frustrated.  Dr. Brooks needs the exact thing Anthem wants me to do (during this diet) so I can have the correct outcome to be approved for surgery.  I have called Anthem FOUR TIMES!  In the last month, to send me this documented information or tell me where to go so I can print it out.   Every person I have talked to has said, "all it says that you have to do is have a medically supervised weight loss diet: and they tell me that there is no time frame, or anything specific, and I know it has to be!  Because if it was my choice, I would have went on a diet for a day, and submitted my info for approval.   I go back to Dr. Brooks on Thursday, and there is still no information regarding this diet in my hands!!!!  Has anyone had to go through this with Anthem and know their policy, or does anyone even work for anthem, and could tell me where I could get this info.  Because I need it, and it is just making me so effin frustrated!

I have highmark bcbs, but in log in online.  Then went to my medical policy.  Looked up obesity, and then printed it off. Best wishes, KIM

I have BCBS. Is Dr. Brooks your PCP? If that is so all you need to do is your 6 months  with him/her, and then let your Baritric center take over from there. I went once a month to Dr LYnch (1 more to go)The oofice weighed me and We talked about what I was doing regarding changing my lifestyle.I did a food journal for the first couple months and wrote down everything I ate and drank and recorded my weight as well. This was suggested by my pcp to do this.I also was diag. with diabetes and she would write down all that info, also my high blood pressure and all those stats.One visit we disscussed my PANNI and my small little boils I get on it.Then on my 5th, I had you type up a letter for recommendation for the surgery and made copies of all my records for Clarian.Whatever center you are going to knows what you need and will call your Insurance company to double check.In fact at Clarian you can even do your Supervised diet with them. If you have any Questions PM me. Thanks Shanna

Sorry brok I don't have any clue hon. My insurance didn't require anything but proof that I was morbidly obese.

brok you have mail . read it and get with me

I originally had Anthem.  I was told I had to have a medically supervised 6 month diet and exercise in writing.  It could not be WW.  I went to my PCP every month for 6 months.  At the end of 6 months, I called Anthem again.  Their policy changed.  I had to have 18 months instead.  I was able to change insurances at the beginning of the year at open enrollment time, and I did.  I went to United Healthcare.  My information was resubmitted by the surgeon's office and it was declined.  When I called to find out why, the information was old (almost 2 years!) and I had actually gained weight and had other co-morbities.  So I had new records sent and a submitted a letter asking them to re-look.  I was approved.   But Anthem seems to be the insurance everyone has problems with.  I would definitely look up my "booklet" online to see EXACTLY what it says.   Good luck!

Brok, All I had to do with Anthem for my RNY and for my recent plastics was call the number on the back of the insurance card. With each surgery, I requested that they send me a copy of the policy and I had recieved it within a week each time. When I called, I was instructed to enter my ID..that is so that they can pull up the policy that is effective for the company you work for. Some folks think that all Anthem policies are created equally. They aren't. The policy you have is dependant on the one your employer was willing to pay a portion for. Think of it like car insurance. Let's say you & I are both through Progressive. If you want a $200 deductible, your policy is going to cost more than mine if I  choose a $500 deductible.  At the time that I had my surgery, MY policy stated that I didn't have to have a supervised diet at all (although, I did...oh...and Indiana state law dictates that no insurance company can require any longer than 6 months of physician supervised dieting so if any Indiana resident insured in Indiana are told longer than that, they need to do some checking into why their insurance company is breaking the law! This became effective almost 2 years ago.) and I also had no co-pay for any of it. Since I had already had my deductible for the year paid, my surgery cost me nothing. I know of others however who had to pay 20-50% of the costs..and still through Anthem. My employer switched their policy coverage with Anthem as of 1/1/08. My upcoming surgery is suppose to cost me 20%.  Good luck, Sherri ps...by the way, Dr. Brooks office CAN call the insurance company and request that they fax a copy of the policy to their office.

Thank you so much guys!!!  I think I finally have the info I need.  I really appreciate all of you guys responses...ugh all of these loopholes!...lol

I have anthem. They told me it was a six months diet, and it needed to be documented each month that I was weighed, and that we discussed diet AND exercise.