No Previous Weight History?

[emily111 3]

OK so I did all I am supposed to do. I have my 6month diet also 5 months with a nutrtionist. I did the sleep apt study. I did the phyc eval. I did everything I had to do. So its time to file on the 23rd (my patient advocate is out until then) and I was reading over the requirements for bcbs of MN and it says 2 year weight history. Hmmm why didnt my patient advocate mention this as a big deal? So I call bcbs of MN and they say oh yea that will be a problem if you dont have a weight history. So now I am freaked!!!! I found one doctor apt and guess what I was on a diet at the time and my BMI is 36. Right now my BMI is 41 with no co morbities. I am so scared I will be denied. I know yall know from my other post that my dad just died and I am having such a hard time in general and this 6 month thing has been so stressful I actually gained weight on it. :teeth_smile: SO please give me your experience with this. What happened to you if you didnt have the weight history or history but under the 40 BMI? SOmeone help calm me down please :biggrin: I am so nervous I feel sick and I know all I can do is wait but I guess hear the experience of other will help :biggrin:

[bxlisa 0]

Did you ever join a weight loss program like Weight Watchers?

I turn in my membership cards as weight history documentation because they recorded my weight and stamp the dates.

[Froggi 4]

I didn't have a weightloss history though I had lost and gained several times. That is whymy insurance wanted the 6 month diet. I don't understand why some want both. =/

[emily111 3]

hmm i wish they didnt want both but they do lol meanys and yes i lost 60 pounds on WW I also gained it back but I did it at home and bought the WW material on ebay :biggrin:

[laurenwhite82 0]

Mine is making me have the 6 month diet plus 2 years documentation of my BMI being over 40. So far I have one year but Im having to scrounge around for the other! What totally sucks about it is that I went to the dr plenty of times at my student health center (I was in grad school for the last 2 years) and they didn't weigh me!! This has been the case for a few of my drs...they just didnt weigh me...not entirely sure what to do about that.

[Froggi 4]

I was never weighed in normal doc appts anyway. The scale never went high enough to get my weight.

[bxlisa 0]

I would call the insurance company’s member services and have the rep send you the coding for bariatric surgery documentation. Sometimes member service doesn’t explain everything to you over the phone. There might be an alternative to get around stuff.

For example, I had to choose between a six months diet with an A*** network dietitian or have a private bariatric dietitian for three months. I choose to see the private dietitian which I had to pay out of pocket first.

I also had to get two years documentation of my BMI being over 50 but dietitian and staff worked really fast with pre-certification process. They clue me in with a lot of stuff.

Did you go to the GYN; they probably have your weight information in their records?

If you just type a really nice report with your weight gains with photos stamp dates and weight related illnesses including irregular periods.

List Current Year: 2008 Weight: ______________

Year: 2007 Weight: ______________

Year: 2006 Weight: ______________

Year: 2005 Weight: ______________

Year: 2004 Weight: ______________

Year: 2003 Weight: ______________

Name every type(s) of diet(s), if any, have you followed in the past.

Alternative Medicine, Fad Diets, Overeaters Anonymous, Jenny Craig, Over the Counter Diet pills

Like you mention, froggi1975 the doctor couldn't weight you because the scale never went high enough to get your weight. He should have sent you to another doctor if he didn't have the tools to treat you properly. Never settle for bad health care service. Remember you pay them!

Try sending the insurance company all this information – sometimes it helps. You can always appeal and appeal the decision.

From the insurance perspective, weight loss surgery has always been considered “medically necessary.” This means that weight loss surgery is not considered cosmetic but rather is performed to decrease the health risks associated with severe obesity.

Lastly you can always try to finance it at www.capitalonehealthcarefinance.com

Hope this helps!

[emily111 3]

wow thanks bxlisa. That really helped I was thinking of doing that. I mean I did everything they asked and I never once thought that the weight history would be a problem. I do have one apt. with my OB dr but my BMI was only 36 like I said before I have lost all the weight in the past I just gain it all back later. I am going to write this nice letter and have everyone I know sign it and include there phone number I will also look for pics even though I never took any when I was over weight if one was taken I would throw it away lol. Good ideals really :rolleyes2: I also decided to have an appeal letter ready so if they deny me I can just say here you go I have been through heck this past 6 months because of them.

[aprilapple 1]

My insurance co.-bc/bs allows the use of photos as documentation.

[Blaze21 5]

I didn't have documented weight history either. My wonderful PCP wrote an outstanding letter to my insurance company, with all of the programs that I've been through, the diet pills, etc. I believe this was instrumental in getting my approval.

[Tamihott 0]

My insurance carrier BC/BS illinois requires a 5 year history of morbid obesity!! I was ready to file last week and the bariatric cooridiantor called and said I am missing 2004. I did not go to the doctor in 2004 at all. I had just moved from fl to pa. I was told to try and get 2003 well I did and that was the time I had just lost 40lbs on the Atkins diet. I followed the advice of this site and wrote a letter explaining the circumstances and photos. The packet goes out this week. If I am denied I will wait untill 2009 and resubmit as all paperwork for ins (6 month diet is good for 24 months)!! Good luck to us both! Tamara