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Insurance savy person, help!

Read2016

By Read2016, in Insurance & Financing

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Read2016    658

Read2016
Posted

Hi All,

Looking to find someone who may be a teacher in NYC or someone else with this type of insurance.

Had my first consult with the surgeon today, loved her.

The guy who handles the insurance is giving me information not stated in the plan.

I'm going to post what the plan says and maybe someone out there can tell me what kind of things fall under 6 months continuous. He's insisting it's medically supervised but I don't see that word anywhere.post-288810-14612808655983_thumb.jpg

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KristenLe    5,979

KristenLe
Posted

I would assume that he's interpreting the 6 month weight loss program has to be "appraised and documented by physician requesting referral" as medically supervised. I would specifically question what appraised means to them.

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shrinkingkimber    200

shrinkingkimber
Posted (edited)

That's exactly what mine stated. My doctor looked over my food and exercise journals (from myfitnesspal)for 2 months and signed off on them then I continued seeing her for 4 months and that made up all 6 months.

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Edited by shrinkingkimber

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Read2016    658

Read2016
Posted

I'm trying to see if I can submit things like working with a personal trainer etc... Thanks your response is a big help... Did you have bcbs?

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shrinkingkimber    200

shrinkingkimber
Posted

I'm trying to see if I can submit things like working with a personal trainer etc... Thanks your response is a big help... Did you have bcbs?

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Yes. My document looks just like yours just with a different emblem up top. post-269560-14612837533932_thumb.jpg

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shrinkingkimber    200

shrinkingkimber
Posted

Yep so your doctor just reviewed your documents and submitted a letter stated they had reviewed them?

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My surgeons office actually had a form that had to be filled out for each month. I printed my journals from each month and she reviewed them then filled out the surgeons form for each month/journal.

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shrinkingkimber    200

shrinkingkimber
Posted (edited)

Where are you? Maybe I'll be headed to your doctor... How's the weight loss going

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Virginia. I haven't had my surgery yet. I finished my 6 months as of April 1 but due to a medication that I'm on my surgery has to be 8 weeks after the last dose. My surgery date is 6/9.

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Edited by shrinkingkimber

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Amurillo04    109

Amurillo04
Posted

I have that insurance as well and unfortunately as most insurances it needs to be under a doctor. The insurance coordinators have a pretty good idea of what there doing -most of the time- and it's basically there job to get you approved because they want that 30 grand from you lol

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