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Topic: RE: 5 year weight history - BMI under 35
I have UHC as well. I think it depends on your plan, but with ours I have t ocome up with the 5 years weight history to prove a BMI of >35 plus comorbitities. Mine would hypertension.
I also have to get a letter from my PCP to my surgeon explaining why he thinks this surgery would be beneficial for me.
Then, I have to have my consultation with the surgeon. Once he recommends a surgey he will submit my 5-year history, letter from PCP and his letter of recommendation to UHC. From what I've heard the approval/denial process through UHC is fairly quick as long as all your paperwork is together.
I also have to get a letter from my PCP to my surgeon explaining why he thinks this surgery would be beneficial for me.
Then, I have to have my consultation with the surgeon. Once he recommends a surgey he will submit my 5-year history, letter from PCP and his letter of recommendation to UHC. From what I've heard the approval/denial process through UHC is fairly quick as long as all your paperwork is together.
Topic: RE: 5 year weight history - BMI under 35
I am still in approval process. I have UHC. I do have co-morbidities also.
Topic: RE: 5 year weight history - BMI under 35
She did have a 4 year history of BMI over 40. Our insurnace requirements were to have a BMI of >40 with no co-morbidities or >35 with at least 2 co-morbidities. She was denied due to lack of 2 year history of obesity as defined above. the reason being, originally 4 year history of proof of obesity was submitted, but within those 4 years, she had an office visit where her bmi dropped below 40 during one of the years. But she also had a recorded weight of a bmi of over 40 in that same year. So when filing the appeal, we did not include that one office visit because she did have other office visits in the same year where she was clearly way above 40.
Have you been denied? Or are you still in the approval process? Who do you have insurance with?
Have you been denied? Or are you still in the approval process? Who do you have insurance with?
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: RE: 5 year weight history - BMI under 35
What was the basis for the appeal? Did she have co-morbidities?
Topic: RE: 5 year weight history - BMI under 35
Yes, actually that was the reason my daughter was denied at first, but we appealed and won the appeal. Normally, if your BMI drops below the 'required' BMI during that 5 year history, you will get denied. In our case, we only needed a 2 year history, not 5. We have Aetna insurnace.
Nan
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: RE: FINALLY!!! APPROVED!!!! THANK YOU!
Can you send me a copy of the letters? [email protected]
Topic: 5 year weight history - BMI under 35
Anyone have issues with 5 year weight history for insurance purposes and some years that your BMI didn't quiet meet the obesity level
Topic: RE: 6 month diet/gained weight!?
For those of you that gained weight did you gain over all months of the insurance required diet or just during the last month? Overall, I lost 14lbs it was just the final month where I ended up being the same weight as the previous month (looked like I had gained but really had just stayed the same). I had full 6 months not 6 visits. I debate going for one more month...should I have a visit in November or just submit? I don't know if it really matters..
Topic: RE: Peer to Peer, succesful!!!!
Congratulations!!! That is wonderful that your surgeon fought for you! Good luck with your surgery!
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010
Topic: RE: FINALLY!!! APPROVED!!!! THANK YOU!
Maria!!!!! Congratulations!!!!! This is GREAT news!! I am very happy for you!!
Nan
Nan
Nan
HW 300 / SW 280 / CW 138 / GW 140
Hit Goal 4/2/2010