Medically supervised diets and approval

[Guest guest]

Hi,

Hi all, need your input:

I'm just getting started, and have a consult next month with Rabkin.

I was told to bring all my " documentation " including medically

supervised diets.

I don't know how everyone else is here, but I stopped talking to docs

about dieting years ago, because the 1200 calorie diet thing and

exercise was all they offered and after several attempts, I just gave

up on it.

I can wax and wane for hours about diets I've tried in my life, gained

and lost 100's of pounds, but not written down on some doctors chart

somewhere.

Was a medically supervised diet a major factor or not, does anyone

know, in getting denied? I'm getting freaked about this.

I have a BMI of 60, am age 48. I can pull together some stuff on

comorbids: borderline diabetic (documented), have joint problems

(getting documentation), borderline sleep apnea (undocumented) and

reflux (undocumented). I thought I was so smart figuring out what I

needed to do for all these (cut back on carbs and sugar, not eat late

at night, etc etc) just not a doctor-goer. I'm intelligent and

informed and now I am faced with needing some doctor to have written

all this stuff in my chart....

Any thoughts?

[Guest guest]

Hi,

Hi all, need your input:

I'm just getting started, and have a consult next month with Rabkin.

I was told to bring all my " documentation " including medically

supervised diets.

I don't know how everyone else is here, but I stopped talking to docs

about dieting years ago, because the 1200 calorie diet thing and

exercise was all they offered and after several attempts, I just gave

up on it.

I can wax and wane for hours about diets I've tried in my life, gained

and lost 100's of pounds, but not written down on some doctors chart

somewhere.

Was a medically supervised diet a major factor or not, does anyone

know, in getting denied? I'm getting freaked about this.

I have a BMI of 60, am age 48. I can pull together some stuff on

comorbids: borderline diabetic (documented), have joint problems

(getting documentation), borderline sleep apnea (undocumented) and

reflux (undocumented). I thought I was so smart figuring out what I

needed to do for all these (cut back on carbs and sugar, not eat late

at night, etc etc) just not a doctor-goer. I'm intelligent and

informed and now I am faced with needing some doctor to have written

all this stuff in my chart....

Any thoughts?

[Guest guest]

Some insurance companies (Including Aetna) like to see medically

supervised diet histories. However, in some cases they will take your

own records. Get your medical records for the last 5-7 years. I am

sure they weigh you. If you can show a pattern of up and down weight

then you can assign a diet to them it will help. Did you ever do the

phen-phen thing? What about Xenical? You could ask your Dr. to put

you on it right away just to show that it doesn't work. With your

BMI and comorbids you shold have a good case. Of course you may face

this DS is " investigational " problem.

Also, just want to make sure you are aware that Dr. Rabkin takes his

$11,000 fee up front (at time of surgery scheduling) and your

insurance will probalby only reimburse $2500-$4000. If you are not

prepared to be out of pocket that much then you should consider Dr. K

in Delano or Dr. Anthone at USC or Dr. Welker in Eugene. One gal

went through the whole process with Dr. R only to find out that she

would have to put down money she didn't have. What a bummer.

Hull

> Hi,

> Hi all, need your input:

>

> I'm just getting started, and have a consult next month with

Rabkin.

> I was told to bring all my " documentation " including medically

> supervised diets.

>

> I don't know how everyone else is here, but I stopped talking to

docs

> about dieting years ago, because the 1200 calorie diet thing and

> exercise was all they offered and after several attempts, I just

gave

> up on it.

>

> I can wax and wane for hours about diets I've tried in my life,

gained

> and lost 100's of pounds, but not written down on some doctors

chart

> somewhere.

>

> Was a medically supervised diet a major factor or not, does anyone

> know, in getting denied? I'm getting freaked about this.

>

> I have a BMI of 60, am age 48. I can pull together some stuff on

> comorbids: borderline diabetic (documented), have joint problems

> (getting documentation), borderline sleep apnea (undocumented) and

> reflux (undocumented). I thought I was so smart figuring out what

I

> needed to do for all these (cut back on carbs and sugar, not eat

late

> at night, etc etc) just not a doctor-goer. I'm intelligent and

> informed and now I am faced with needing some doctor to have

written

> all this stuff in my chart....

>

> Any thoughts?

[Guest guest]

Some insurance companies (Including Aetna) like to see medically

supervised diet histories. However, in some cases they will take your

own records. Get your medical records for the last 5-7 years. I am

sure they weigh you. If you can show a pattern of up and down weight

then you can assign a diet to them it will help. Did you ever do the

phen-phen thing? What about Xenical? You could ask your Dr. to put

you on it right away just to show that it doesn't work. With your

BMI and comorbids you shold have a good case. Of course you may face

this DS is " investigational " problem.

Also, just want to make sure you are aware that Dr. Rabkin takes his

$11,000 fee up front (at time of surgery scheduling) and your

insurance will probalby only reimburse $2500-$4000. If you are not

prepared to be out of pocket that much then you should consider Dr. K

in Delano or Dr. Anthone at USC or Dr. Welker in Eugene. One gal

went through the whole process with Dr. R only to find out that she

would have to put down money she didn't have. What a bummer.

Hull

> Hi,

> Hi all, need your input:

>

> I'm just getting started, and have a consult next month with

Rabkin.

> I was told to bring all my " documentation " including medically

> supervised diets.

>

> I don't know how everyone else is here, but I stopped talking to

docs

> about dieting years ago, because the 1200 calorie diet thing and

> exercise was all they offered and after several attempts, I just

gave

> up on it.

>

> I can wax and wane for hours about diets I've tried in my life,

gained

> and lost 100's of pounds, but not written down on some doctors

chart

> somewhere.

>

> Was a medically supervised diet a major factor or not, does anyone

> know, in getting denied? I'm getting freaked about this.

>

> I have a BMI of 60, am age 48. I can pull together some stuff on

> comorbids: borderline diabetic (documented), have joint problems

> (getting documentation), borderline sleep apnea (undocumented) and

> reflux (undocumented). I thought I was so smart figuring out what

I

> needed to do for all these (cut back on carbs and sugar, not eat

late

> at night, etc etc) just not a doctor-goer. I'm intelligent and

> informed and now I am faced with needing some doctor to have

written

> all this stuff in my chart....

>

> Any thoughts?

[Guest guest]

In a message dated 8/18/01 2:15:00 PM Eastern Daylight Time,

netmaker2@... writes:

> Was a medically supervised diet a major factor or not, does anyone

> know, in getting denied? I'm getting freaked about this.

>

>

I was never on a medically supervised diet and have never taken Redux,

Meridia, etc. I was on Weight Watchers numerous times, Powter, Atkins,

took Mahuang and Chromium Picolinate, other herbs, Nutrisystem and the list

goes on and on. I had no problems getting approval regarding the past diet

attempts. What they did get on was wanted more information (proof) of

chronic back pain and being on pain killers for it. Luckily I had requested

ahead of time my medical records showing I have been to an orthopedist and

physical therapist and the ortho even mentioned the possibility of pain

management in my records. I think each insurance has their own quirks.

[Guest guest]

In a message dated 8/18/01 2:15:00 PM Eastern Daylight Time,

netmaker2@... writes:

> I can pull together some stuff on

> comorbids: borderline diabetic (documented), have joint problems

> (getting documentation), borderline sleep apnea (undocumented) and

> reflux (undocumented).

FYI, my insurance only accepted Diabetes, Hypertension and back pain as co

moribidities. I couldn't even use my Gerd, hernia or other problems. Thank

God I do have back problems or I never would have gotten approval. Sleep

apnea will be documented so don't worry about that. Gerd will be documented

if they order an endoscopy which they almost always do. Sounds like you have

everything in good order for insurance.

[Guest guest]

In a message dated 8/18/01 2:15:00 PM Eastern Daylight Time,

netmaker2@... writes:

> I can pull together some stuff on

> comorbids: borderline diabetic (documented), have joint problems

> (getting documentation), borderline sleep apnea (undocumented) and

> reflux (undocumented).

FYI, my insurance only accepted Diabetes, Hypertension and back pain as co

moribidities. I couldn't even use my Gerd, hernia or other problems. Thank

God I do have back problems or I never would have gotten approval. Sleep

apnea will be documented so don't worry about that. Gerd will be documented

if they order an endoscopy which they almost always do. Sounds like you have

everything in good order for insurance.

[Guest guest]

In a message dated 8/18/01 9:08:22 PM Eastern Daylight Time,

alyssaj@... writes:

> Which insurance carrier do you have? I'm wondering what to expect with

> Cigna PPO...

>

> I also have back pain, but I can go for months without seeing the

> chiropractor (although there was a time I had to see him at least

> once/month). Would that count as a comorbidity at all??

>

I have HIP Heritage. On obesityhelp.com you can look up Cigna PPO and see

what others had to say about them. While insurance companies have their

similiarities, some require more then others, some less. Back pain is

usually considered a co-moribidity but if you claim it be sure you can prove

it. Sometimes a letter from your PCP is all it takes, sometimes they may go

and ask for records. Your surgeons office should be very familiar with the

different insurances and should be able to help you immensley.

[Guest guest]

Re: Medically supervised diets and approval

> FYI, my insurance only accepted Diabetes, Hypertension and back pain as co

> moribidities. I couldn't even use my Gerd, hernia or other problems.

Thank

> God I do have back problems or I never would have gotten approval.

Which insurance carrier do you have? I'm wondering what to expect with

Cigna PPO...

I also have back pain, but I can go for months without seeing the

chiropractor (although there was a time I had to see him at least

once/month). Would that count as a comorbidity at all??

alyssa