Second Weigh in / Insurance / Sigh

[justpeachytexas 0]

Well yesterday was my second weigh in. Good news is that I lost 9 lbs. and my BMI is 39.3. The bad news is if I keep up the "good work" for the next 4 months insurance will probably turn me down <?xml:namespace prefix = v ns = "urn:schemas-microsoft-com:vml" /><v:shapetype id=_x0000_t75 stroked="f" filled="f" path="m@4@5l@4@11@9@11@9@5xe" o:preferrelative="t" o:spt="75" coordsize="21600,21600"><v:stroke joinstyle="miter"></v:stroke><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"></v:f><v:f eqn="sum @0 1 0"></v:f><v:f eqn="sum 0 0 @1"></v:f><v:f eqn="prod @2 1 2"></v:f><v:f eqn="prod @3 21600 pixelWidth"></v:f><v:f eqn="prod @3 21600 pixelHeight"></v:f><v:f eqn="sum @0 0 1"></v:f><v:f eqn="prod @6 1 2"></v:f><v:f eqn="prod @7 21600 pixelWidth"></v:f><v:f eqn="sum @8 21600 0"></v:f><v:f eqn="prod @7 21600 pixelHeight"></v:f><v:f eqn="sum @10 21600 0"></v:f></v:formulas><v:path o:connecttype="rect" gradientshapeok="t" o:extrusionok="f"></v:path><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:lock aspectratio="t" v:ext="edit"></o:lock></v:shapetype><v:shape id=_x0000_i1025 style="WIDTH: 11.25pt; HEIGHT: 11.25pt" alt="Mad" type="#_x0000_t75"><v:imagedata o:href="http://www.mytrueresults.com/bandtalk/images/smiles/icon_mad.gif" src="file:///C:DOCUME~1ufalaLOCALS~1Tempmsohtml103clip_image001.gif"></v:imagedata></v:shape>and I am having problems with my BP again. Don't know what to do. Keep going and lose the weight I need to and hope I can keep it off this time or lose it and then gain it back again like usual and try again to see if insurance will pay for the band or just say screw it and take the money out of my 401k and then listen to DH and rest of family bitch about screwing up my retirement.<o:p></o:p>

[Pix 4]

Well, from everything I have read here the doctor submits the initial weight with the paperwork.

Don't quote me though, I didn't have to jump through the insurance hoops, just military hoops.

[justpeachytexas 0]

:wink2: I would think military hoops would be harder, but I forgot we are dealing with insurance companys.

[Laurinda 1]

I know what you mean about the 6 month diet you have to do before insurance will look at paying for the surgery. I made sure to lose weight but near the end of my six months I also made sure not to lose to much. I feared if I did the insurance would say "Hey you can do it by yourself" If I could "do it by myself" and keep it off I wouldn't have looked into the band!

[kdlee 0]

I think the insurance company goes off your weight from the start of the diet. The 6 month diet is to show that you can commit to a weight loss program, so weight loss is a good thing.

[purplee33 0]

From what I understand the doctor's office will use the initial weight for your insurance submission. That's what my doctor did. By the way I am from Rhome too. (Small world)

Purplee33

[kathystrick 3]

Check with your doctor's office and see what weight they use. Your worry could be alleviated with one simple phone call. Good luck!

[tas 0]

I am two month's into my six month diet also. My initial BMI was 36.2 but I have two co-morbidities I am banking on for approval. I know I can lose enough weight to get under the 35 limit but it will come back as always. I asked about this at the Clinic I'm using and they told me to be careful not to lose too much. So I haven't changed a thing and I'm just basically putting my time in to show I did the six month's. I have heard also that they use the inital weigh in weight but I'm not taking any chances.

Good luck

[justpeachytexas 0]

True Results also asked for me to keep a diary of what I eat and exercise. I am having issues with my BP. I wonder if this would be considere a co-morbidity (sp?)

[purplee33 0]

Most insurance companies consider high BP a co morbidity as long as it is well documented by your Dr.

Edited May 20, 2008 by purplee33
spelling

[kathystrick 3]

How are all of you doing on your food diaries? If one is actually supposed to be dieting but isn't, I am assuming one would have to lie about what they are eating? Hey, whatever it takes to get approval is what I say!!

[JAK 0]

Since I'm so close on the minimum BMI - I had to be very careful not to lose much weight or it would put me below...Okay - and I admit...I had to cheat on my food diaries in prep for submission to my insurance. I even had one of my staff help me prepare them by putting down her meals cuz I wasn't very good at keeping up on them daily, weekly...monthly (I'm ashamed). Interestingly enough - when Doc's office was preparing to submit to Aetna I mentioned that I had to fill in some holes that I had missed on my food calendars and she told me that they simply do a summary when submitting. Who knows - I just got the call from the Insurance Advocate yesterday advising me that everything was in order and they submitted to Aetna...now I'm just waiting it out to see if I'm approved...and biting my nails to the quick! I have 3 left - they'll be bitten by the time the insurance responds I'm sure!

[justpeachytexas 0]

I was thinking about what JAK did. With my BP i had issues a couple of years ago. I still have the BP cup at home I will start monitoring it and if it was like yesterday time to go back to my PCP.

Thank you everyone :cursing:

[kathystrick 3]

Since I'm so close on the minimum BMI - I had to be very careful not to lose much weight or it would put me below...Okay - and I admit...I had to cheat on my food diaries in prep for submission to my insurance. I even had one of my staff help me prepare them by putting down her meals cuz I wasn't very good at keeping up on them daily, weekly...monthly (I'm ashamed). Interestingly enough - when Doc's office was preparing to submit to Aetna I mentioned that I had to fill in some holes that I had missed on my food calendars and she told me that they simply do a summary when submitting. Who knows - I just got the call from the Insurance Advocate yesterday advising me that everything was in order and they submitted to Aetna...now I'm just waiting it out to see if I'm approved...and biting my nails to the quick! I have 3 left - they'll be bitten by the time the insurance responds I'm sure!

So you are just waiting on approval?? Woo hoo!!!:wink2: You will have it before you know it! The wait now won't be nearly as long as it has been. Keep us posted!