All New To This.. Please give advice
As I can see from reading these message boards, everyone has issues with the insurance part of WLS. Let me tell you where I am in my WLS experience, just to get some advice on the forefront.
I am 323 lbs, and have had a weight problem all of my life. I had gestational diabetes with my last pregnancy 2 yrs ago, and now have prediabetes. I also have a underactive thyroid, which contributes to my weight gain.
I have met with my surgeon, he says he is ready to proceed immediately, of course, after my insurance approves my surgery. My surgeon's office says they won't turn in all of my paperwork to the insurance company until I have a 6 month dr supervised diet, letters from my PCP, a full physical and mental health eval. I have my PCP appt on Tuesday of this coming week, as well as my mental health eval. I have been on MANY diets in the last 2-3 years, just none have been Dr. supervised. Also, I called the Utilization Mgmt group of my insurance and they told me it could be either 6 months of dr supervised or 2 3 month stints with Weigh****chers or Jenny Craig (they would need my food diaries).
Does anyone have any advice on what I can ask my doctor for on Tuesday, to try and get this approved ASAP. I have been contemplating the surgery for more than a year now, and to wait another 6 months would literally kill me. I know many people have had to wait the 6 months, but if I can find something to give me some hope, it would be much appreciated. I don't want to say I want to "make up" the food diaries.. but I am tempted at this point.
Thanks for your time and help!!!
Kelly Gilroy
Was scrolling through things and was wondering of you could send me this packet...
[email protected]
Thanks so very much in advance.....
I'm in the process also. My surgeon visit was where I presented my documentation. I also gave them family history and any type of documented diets and dr visits that I could show my weight. They filed it with my insurance and then my insurance wanted six more tests ran; cardio clearance, pulmonary clearance, hpyloric blood test, psych eval, nut consult, and treadmill. I have been calling both the surgeon and insurance at the end of each week to check on updates. My pcp has been faxing my surgeon the results as my tests are completed. Then when the surgeon has all of the info they will do their final submit of insurance. Sounds complicated, but hopefully it will all be finished soon. Just stay in communication with each and make sure they know you will be on top of the paperwork.