Uugh Oxford!!! They Changed Their Requirements!!!!

[RNDiva 0]

After finally submitting all of the required paperwork, completing nutritional and psyche consultation and finally building up enough courage to go through with the lap band procedure I am told that I now have to have 6 consecutive months of medically supervised weight loss program documentation- which I did not do :( . Now back to square one. So discouraged and depressed. Now I have to wait six more months before submitting documentation for insurance approval again. Just wondering when did the Oxford change their policy?

[thinspiration 7]

Hey, what kind of Oxford do you have? I have Oxford under United Healthcare. I'm not sure if you have a different kind of Oxford. I had my surgery 12/20/11. At the time when I contemplated surgery, I called Oxford insurance to inquire if they covered, they said yes. The requirements were that if you had a BMI between 35-40 you had to have one or two comorbities to be approved. If your BMI was over 40 that's all you needed to be approved. Mine was 46. All I did was complete my surgeon requirements and they submitted my paper work and i was approved within a day with no weight loss program required. It was pretty quick for me. I had my first consult on 10/18/11. I got my requirements done quickly and I was on the table 12/20/11. It's unfortunate that they are requiring medically supervised weight loss. I know sometimes when you want something done and you have made up your mind, you want to get it over with.

YOu should ask if your previous attempts at weight loss is acceptable for approval. Sometimes that may be good enough.

P.S. Try not to lose too much weight on the Medically supervised program because they may deny you because they may feel you can do it on your own.

[SashaWLS 412]

I had the same thing happen, but the surgical coordinator said to sit down with my PCP and have him write up everything he could think of to document a history of trying to lose weight. I mean, if he could write down every time he weighed you and you talked about it, it might be 6 months!!

[DeAna N 229]

I am so sorry for you one option is to get your PCP to print out all your vitals that show your wieght and if he had a conversation with you about the importance of getting your wieght down( which they never fail to mention) at those visits it can be considered a "supervised" weight loss. it might work or at least shorten some..Good Luck