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Getting my ducks in a row for insurance criteria



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I had my consult with the bariatric surgeon on June 30th. He recommends the sleeve and I agree. My insurance requires 90 days of medically supervised weight management by either a physician or a reg dietitian. I'm using a dietitian. I had my first appointment ONLINE with her on July 15th. My next one is scheduled for Aug 18th. I'll have another Mid-September and likewise in Mid-October. My insurance requires recommendation from my pcp as well as a pysch eval and clearance from a psychiatrist. I had the psychiatry appt this morning (7/24/14) and spoke with my pcp about it in another appt this afternoon. Psych has to score my tests and will let me know. PCP thinks its a great idea. That'll take care of my insurance criteria. However, I have active auto immune disorders right now. I need them to be under control before surgery. I saw my rheumatologist a week ago (7/17) and she said that she doesn't think the surgery is a good idea right now. Right now priority should be getting my lupus under control. I agree. I've been taking my meds as directed right from the get go (saw her for first time 5/20). I told her that due to the insurance criteria, surgery wouldn't even be possible until the end of the year. I see her again in 2 months and she said we'd discuss it again, then. Meanwhile, I'm on daily steroids, immuno-suppressant, and blood thinner. I really hope these meds do the trick and put me back into remission. fingers crossed. But, I'm using the time now to really work on me.

Edited by rossigrl84

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I think we are on the same timeline, and your insurance criteria is identical to mine. I am in Mississippi. I just started my 3 months of monitored weight loss and have had my psych eval. Dietician appts start next week.

I do not know much about lupus, but I hope that your meds get it under control. Take care of yourself with this.

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@@MS_Science_Sleever I'm glad to have someone to virtually walk through this journey with. I have cigna insurance? Do you have the same?

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no, I have BC/BC state emplpyee insurance - which is different than the regular BC/BC of MS.

I am surprised to see how many people are on this site. I am looking forward to journey - because I know it will be hard and worth it...... and we will look fabulous and be really healthy and feel good in the end.

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