My provider CHANGED the rules!

Dutchgrl59 · 02-05-2006, 12:17 PM

Well Folks.... don't think it won't happen! I am some 8 weeks into the process and my Insurance provider (PacifiCare/Prospect Medical) has changed it's requirements. The standard 6month supervised weightloss, dietician visit, psch evaluation etc, etc has now been upgraded for me. In order to have my consult with the Bariatric Surgeon I need to :
Visit the Dietician and have 2 follow-ups (note thats 3 appts) and have a Psch Evaluation and 3 follow-up visits (note thats 4 appts). And each visit needs an offical referral letter. Who thought up this hair-brain idea. The medical group lady said that this was the answer to Cigna and some other company who has decided to ban WLS altogether. So my company decided to add 5 visits.... just for fun. While I had the girl on the phone I asked, "can I make these appts consectutive ie; one on Mon another on wednesday and so on" She said yes.... if I could book them. So, next week I will be calling in a referral for 1 follow up dietician and 1 psch eval and then book them in the same week. During the visit I will book 2 more visits until I have checked them all off. I really wish gasoline isn't nearly $3 a gallon cause thats what I'm wasting. Thanks for listening gang I have some phone calls to make.

Tootarts · 02-09-2006, 07:44 AM

It took me 11 months to go through all the insurance requirements. it's Bull*^#* if you ask me and they say that it's necessary because they want to make sure your comitted to the program. I think just commiting to surgery is a tough enough decision and then having to go through everything is awful.
Hey at least you don't have to go to a physical trainer like they required us to do and pay 400 dollars out of our pockets for too!