VSG for dummies (Insurance rant)

[Patti K 98]

So how is it even fricking POSSIBLE that the hospital who I am going theough for the surgery forgot to send the proof that I am in their program??? UHC got everything BUT the proof that I am officially enrolled in a weight loss surgery program. I said the hospital that submitted it THAT is the program I am in. They said they need proof. WHAT? My hospital does 5-7 surgeries a day and work with UHC all the time. They have GOT to be kidding. Rant off.

[Fiddleman 4,376]

Did you find this out day of your surgery? Hopefully not...

[Patti K 98]

No, I am trying to get y insurance to APPROVE it! And they freaking say they don't have proof of my being enrolled in a WLS program....

[lifer 39]

Do they mean like Weight Watchers or something to prove that you've tried other methods? That's all I can think of. Sorry

[bdiddy13 32]

I had to do a "6 month, medically supervised" weight loss program.. Which meant that l did weight watchers, and during that 6 months, l had to meet with my primary Dr 3 times where he "supervised" my progress... Then my lns finally approved me... Here is the thing tho, DONT DO GOOD AT WEIGHT WATCHERS!!!! If you do, your lns will say that you dont need the operation because you are doing fine on your own.. Dont lose anything, even gain if you need to... Weight watchers will print you out a week by week of your 6 months... You dont have to stay for a single meeting, just go weigh in so that its recorded

[Brenda0928 145]

So how is it even fricking POSSIBLE that the hospital who I am going theough for the surgery forgot to send the proof that I am in their program??? UHC got everything BUT the proof that I am officially enrolled in a weight loss surgery program. I said the hospital that submitted it THAT is the program I am in. They said they need proof. WHAT? My hospital does 5-7 surgeries a day and work with UHC all the time. They have GOT to be kidding. Rant off.

The Dr may have forgotten to submit it, or the insurance overlooked it....same thing happened to me, we filed appeal with the requested records (again) and a letter from me as well as a cover sheet from the dr specifying exactly what pages contain what info....approved on appeal the next day!! Good luck!!

[Fiddleman 4,376]

I had to do a "6 month' date=' medically supervised" weight loss program.. Which meant that l did weight watchers, and during that 6 months, l had to meet with my primary Dr 3 times where he "supervised" my progress... Then my lns finally approved me... Here is the thing tho, DONT DO GOOD AT WEIGHT WATCHERS!!!! If you do, your lns will say that you dont need the operation because you are doing fine on your own.. Dont lose anything, even gain if you need to... Weight watchers will print you out a week by week of your 6 months... You dont have to stay for a single meeting, just go weigh in so that its recorded[/quote']

Ha! Isn't that funny.what about just losing weight on your own before getting approved? Most of us do lose a little weight or even a lot of weight in some cases before surgery.

[bdiddy13 32]

I lost 40lbs on my own... Then was denied by ins because l didnt do this WW thing.. So during my 6 month WW deal, l only lost another 20, but it wasnt too much where lns would deny me again.. Other people that have different lns dont have to go thru this... I have BCBS... But in the end, it was all worth it.. Im 10 months post op, and down 140lbs.., 200 total if you add in my pre op weight loss.. So either way lm happy

[Patti K 98]

Amazingly I called UHC again and it is a "support program" they offer (which I found out when I googled it when they couldn't figure it out) and I know I signed up for it when I called in January to get their requirements before paying for my hospitals program. So I have to sign up again I guess....

[Brenda0928 145]

Amazingly I called UHC again and it is a "support program" they offer (which I found out when I googled it when they couldn't figure it out) and I know I signed up for it when I called in January to get their requirements before paying for my hospitals program. So I have to sign up again I guess....

I have BCBS MN through my employer and they required 6 months weight loss effort in the last 2 years, with 3 months consecutive in those 6 months, so I just set a monthly appointment with my primary strictly to talk about weight loss efforts, have her weigh me, discuss various diet plans, etc.and she gave me a copy of each office note that I gave to my surgeon...it satisfied the insurance company and the surgeons requirements too. Good luck!!

[Patti K 98]

I googled it and found out that BRS program I need to sign up for is through United healthcare and their customer service didn't even know this