I would call the insurance company’s member services and have the rep send you the coding for b
ariatric surgery documentation. Sometimes member service doesn’t explain everything to you over the phone. There might be an alternative to get around stuff.
For example, I had to choose between a six months diet with an A*** network dietitian or have a private bariatric dietitian for three months. I choose to see the private dietitian which I had to pay out of pocket first.
I also had to get two years documentation of my BMI being over 50 but dietitian and staff worked really fast with pre-certification process. They clue me in with a lot of stuff.
Did you go to the GYN; they probably have your weight information in their records?
If you just type a really nice report with your weight gains with photos stamp dates and weight related illnesses including irregular periods.
List Current Year: 2008 Weight: ______________
Year: 2007 Weight: ______________
Year: 2006 Weight: ______________
Year: 2005 Weight: ______________
Year: 2004 Weight: ______________
Year: 2003 Weight: ______________
Name every type(s) of diet(s), if any, have you followed in the past.
Alternative Medicine, Fad Diets, Overeaters Anonymous, Jenny Craig, Over the Counter Diet Pills
Like you mention, froggi1975 the doctor couldn't weight you because the scale never went high enough to get your weight. He should have sent you to another doctor if he didn't have the tools to treat you properly. Never settle for bad health care service. Remember you pay them!
Try sending the insurance company all this information – sometimes it helps. You can always appeal and appeal the decision.
From the insurance perspective, weight loss surgery has always been considered “medically necessary.” This means that weight loss surgery is not considered cosmetic but rather is performed to decrease the health risks associated with severe obesity.
Lastly you can always try to finance it at
www.capitalonehealthcarefinance.com Hope this helps!