Finally Approved at Long Last

Apr 25, 2009

I'm finally jumping for joy. I called insurance and received a verbal approval on April 23rd, 2009! I haven't written in here for a long-long time because I was really in the pits since insurance denied me back in September because I didn't have the required 12 mo. doctor documented weight loss, and also didn't have my willingness to comply.  So I had Dr. Cote appeal this in October.  My willingness to comply was approved, but I still didn't have enough documentation of dieting!  So I started weighing and measuring with Dr. Cote, my family physician in October 2008.  In November 2008 I was informed that Boeing Traditional had now changed their one year/12 month weight loss requirement to 6 months.  Fantistico!  I turned more information in to my insurance because I figured I had 6 months dieting in the bag.  Not so.....really got pissed off.  Documentation was still too sketchy!  I did, however, have good documentation starting in October 2008.  So to make a long story hopefully a bit shorter.....I made October 16th, 2008 my 6 months doctor supervised diet plan starting date.  This time I made my own documentation dieting chart and had my doctor weigh me in monthly, I joined Weight Watchers online, and then also started attenting WW meetings.  I had Dr. Cote sign my diet plan - I did a diet plan for every other month because my insurance stipulated that I had to see my doctor for reviews at least three times in the six months - beginning, middle, and end.  (I did see Dr. Cote also monthly to really make sure I was covered).  On my created diet plan I had a section for weight, height, blood pressure, measurements.  Then I had a section for:  Exercise, Nutritional Plan I was following (including samples of what I was eating - I did weight watchers), and then another section for behaviorial changes I was making).  Dr. Cote reviewed the charts, added comments, and signed them.  I sent these along with my chart notes to the insurance company.  I also wrote up my starting exercise plan, with time increases and what exercises I had added in along the way, finally with what I was doing now - and pictures of my home exercise room and equipment.  I had Dr. Cote also sign the bottom of all this.  IT FINALLY FLEW AND I WAS OFFICIALLY APPROVED FOR RNY SURGERY ON 22 April, 2009.  Pretty fast this time around since I just had Dr. Cote's office fax it to my insurance at about 1:00 on May 16th.

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