5 Years Worth Of A Primary Care Physician Letter???????

[change 22]

Hi! I have been signed up to this forum and following so many of you for a looooong time!

I previously had tried to start the process under my Insurance from work, but the company I worked for had a clause that did not cover bariatric surgery. I then attempted to do self pay but that all didn't work out so as you can imagine I felt pretty defeated for a couple of years.

However, I am finally able to start going through the process due to the fact that I recently got married and my husbands insurance covers Lap Band!!!Yay!!! So here it goes I have a question. (I checked to see if I could find an answer but for some reason I haven't seen any mention on what I'm about to ask. I may be wrong but hopefully I can get some help.)

I spoke with a friend who had the lapband and we both have the same insurance and she said that they required her to have her primary care physician write a letter stating 5 years worth of her weight history!!!!

I have been very blessed to not get sick very often and if I am sick it is not to the point of going to the doctors, so the truth is I haven't been to the doctor in a looooooong time. I know that I should go for routine checkups but unfortunately I do not.

Have any of you heard about this??? Would this be something that would cause me to be not approved???

I am required to do six months of a physician diet so I do not understand why they would need 5 years worth of history!!! Please Help any comments would be great!

[shues138 35]

_{Every insurance company has different "loopholes" you have to jump through. With my old insurance they told me I had to be on a 6 month supervised diet, my dr's office did the precert and was told bariatric surgery wasn't covered at all! SMDH, so I had to pay out of pocket. Anyway, in regards to the 5 years of weight history, do you go to an ob/gyn once a year? I know when I go for my annual I'm weighed and she has it on file. If anything, I would contact the insurance company and see what they tell you. Good luck!}

[sunshineinbama 5]

yes my insurance did the same thing 5 year weight history i had to go to primary care physician and then to my obgn cuz my dr didnt have my weight for one whole year thats crazy but yes they make you jump through many hoops to have this insurance cover the surgery ...good luck and let us know how things are goin!!!!

[NWgirl 574]

Have you been to any other types of doctors? Gynecologist? How old are you? If you are a younger gal and have been overweight for most of your life, you should try and get your weight records from your childhood doctor.

[change 22]

Thank you all for your help! I hadn't thought about the gynecologist!! I will definitely try that. I will keep you all posted on how it goes. Thanks!

[#MagicWithinme 173]

they want to be sure you've attempted to loose weight. luckily my cardio was keeping good track of my weight showing the yo yo. anything you can turn in to show you've made attempts, herbalife, weightwatchers..

[change 22]

hmm... I have weight watchers too! Thanks Bert!

[PJ Geeser 108]

I too was supposed to fax in my last 5 years of medical records to my surgeon before my initial consultation...I told the nurse that it would be a blank sheet...she said well if you havent been to a doctor you cant make up the records...but you will have to go in anyway for a checkup so the sooner the better as that can be the start of your 6 months of dr. supervised visits that most insurances require as mine does too. My doctor was thrilled to hear I was looking into WLS and had started the process and was behind me 100%. Knew I needed to have a checkup as it had been 5 years since my last child was born so went ahead and made all the appts including my first mammogram and am on my way with my 6 months of supervised visits. Everything came back good to excellent (believe it or not) ! I just want to do something about my weight before I have any major issues...we have LOTS of diabetes in my family and am hoping I can prevent it if at all possible. On a side note.....my personal doctor was not encouraging at all about having lapband and is really pushing me to have gastric bypass...well outright said I should have gastric because better results...That made me torn between the 2 surgeries. I read so many people frustrated on the boards here about not losing etc but also the good too. I know that goes with both surgeries...good and the bad. I think it will be lapband for me....I just hope I can do it with the aid of the band when my time comes. I have been trying to eat healthier, cut the sugars ... trying to cut soda which isnt going the best yet but hopefully by the time I can have surgery i will be there. In a nut shell Kristy...I dont think the 5 years of records is really a big deal. I think you will have previous records that will show your weight etc if they want to look at it. I think they just really want to see that it has been an ongoing issue for awhile and not just a recent weight gain. Keep the process going...there are lots of things to complete in the coming months so time does go fast. I have 4 month left of supervised visits and hoping it will be approved then. You can do it....good luck to you and keep us posted

[change 22]

Thanks PJ! That is definitely encouraging!! We are in pretty much the same boat. I am required to do the 6 months too. I will definitely keep updating on my progress. Wish you the best on your journey as well!!

[BayougirlMrsS 3,934]

Hi! I have been signed up to this forum and following so many of you for a looooong time!

I previously had tried to start the process under my Insurance from work, but the company I worked for had a clause that did not cover bariatric surgery. I then attempted to do self pay but that all didn't work out so as you can imagine I felt pretty defeated for a couple of years.

However, I am finally able to start going through the process due to the fact that I recently got married and my husbands insurance covers Lap Band!!!Yay!!! So here it goes I have a question. (I checked to see if I could find an answer but for some reason I haven't seen any mention on what I'm about to ask. I may be wrong but hopefully I can get some help.)

I spoke with a friend who had the lapband and we both have the same insurance and she said that they required her to have her primary care physician write a letter stating 5 years worth of her weight history!!!!

I have been very blessed to not get sick very often and if I am sick it is not to the point of going to the doctors, so the truth is I haven't been to the doctor in a looooooong time. I know that I should go for routine checkups but unfortunately I do not.

Have any of you heard about this??? Would this be something that would cause me to be not approved???

I am required to do six months of a physician diet so I do not understand why they would need 5 years worth of history!!! Please Help any comments would be great!

Your GYN would have records of your weight. Do you go every year for that? and before you do, check with the insurance provider. Just because it's the same insurance, if they work for different companies, then the coverage may not be the same. I have BCBS of Louisiana and my employer is small and they don't cover my fills..... so i have to pay $235 each fill.... this is why i only go once a year. and the fact that his Office manager is a total B...h.

[change 22]

Thanks Bayougirl!! I will definitely double check on that. I spoke with my UHC Coordinator yesterday who has just linked me with my case manager RN who is going to call me in February and she didn't mention anything about the five year history so I'm keeping my fingers crossed because I know I may have a hard time coming up with 5 years worth. But I will definitely confirm the requirements when my case manager calls. Thanks!

[BayougirlMrsS 3,934]

i had UHC and was not required to do the six monts diet. When you go to your seminar tonight you will probably get a packet. In that packet should be a questioner for you when you call your insurance provider. But you can call at anytime with questions. This is what you pay them for. Call and ask what are the requirements for WLS. They will look up your policy and tell you.

So, now i'm going to fuss you..... no matter how you feel you should go every year for a wellness visit. Most insurance allow this and most of the time its free.

good luck with your seminar and meeting with the surgeon.....

[change 22]

Thanks Bayougirl! I know I know....I promise I will be better with my wellness visits. And you are right...most of the time they are free

Ok so I found out officially that I do have to do the 6 months; however, they will substitute it with weight watchers which I have done. Now to find my old paperwork from 2010 and 2011. They said it could be up to 2 years ago but it has to be 6 consecutive months.

So I know I saw my little Weight Watchers book not too long ago but now of course I can't seem to find it. So I guess we will see what I can dig up. I called the 1-800 number but they said all they can send me is the billing history which doesn't have the weight history on it. I doubt that will be any good.....

Wish me Luck!!! keeping my fingers crossed! It would be so amazing to not have to do the 6 months!!!!!!!!

[BayougirlMrsS 3,934]

girl.... don't fret.... weight watchers keep track of that... go back and see is they have the records.

and i'm going to hold you accountable for future dr. appts......lol

[twi 40]

I was able to proved fives but sometimes only went one time that year. Anyway my surgeon said to check dentist, gym wt watcheers. Anywhere that they