Great West Ins Denial

I have a quick question and I hope that someone can help. I was denied in December for lap band for not having a 6 month supervised physician diet. I am almost done with that  6 months and now what do I do?  What does my pcp need to put in his letter to get me approved. And by the way I am going to go thru a different surgeon than I did in Nov.   Any info would help me thru this .... Thank you

Hey there,  I just joined today but I'm starting my process with GW also.  What I think you should do is contact your GW "case manager", go over what new documentation you can provide and get any suggestions.

I know each insurance is different, I'm going to put in for my surgery in the next week or two.  I'm hoping my 8 mos on LA Weight Loss counts but who knows.  SInce you too are a GW person, please let me know how it goes - as I'm very curious.

Good Luck.

well I hope that works for you I had that on mine also and it was for a year and I still had to have 6 months supervised physician diet......so best of luck with yours.

Not only do I work for Great West they approved my Lapband.  Just make sure your doctor documents everything.  I would submit the 6 months supervised diet history and call customer service and ask for the fax number to the case manager so you can fax that to her/him.  Good luck.

Hi all, I am also working on getting an approval for my lap band surgery. I am working directly with my surgeon ( who performed lap band surgery on my brother  about 6 months ago). They told me that is usually required to HMO to get an approval. I went to nutricionist, and passed psychiatric evaluation. My physicion, by accident requested gastric bypass, for which i got denied. Thank GOD for that, because i did not want that surgery. So now, they told me that I have to be on supervised 6 month program.(nutricion, diet advice etc.) but what is ridiculous about this is that this is done OVER THE PHONE. MY appointments are over the phone. this is crazy. When i got denied for gastric bypass, this was the only reason why it was denied.  So, my surgeon and my physician believe that i should get approved once i complete this program. I just cant wait. Its getting worse and worse, the sleep apnea.... i feel so sleep deprived,  i feel like i wake up 25 times per the 6 hours that i do sleep. I feel tired constantly, and my knee...  i think by the time 6 months  pass i wont even be able to walk at all... :( all those requirements are so difficult

I have GW too.  I was approved and had surgery Dec 11.  They won't approve without the 6 months diet history.  Just have all your monthly Dr weigh in documents with dates that you were seen and have your Dr fax them over to the personal at GW that is handling your claim.  Make sure you follow up and see that they recieve it.  Mine didn't had to be faxed twice.  It took them one week to approve once they had everything .  Good luck..

Thank for all that replied to this ....I just have to sit and wait for 1 more monthly visit with my dr. and then I can reapply to the insurance again..... thanks again.