Re: Insurance approval for DS

[Guest guest]

Hi Ellen: you might try looking at obesitylaw.com for some

reasonable legal advice. I am waiting a decision from my appeal to

my insurer for a DS, and am thinking of taking the legal route if I

am not approved. The lawyers on this site deal with discrimination

against us on a regular basis. I'm not being an ad, just giving you

another resource. Also, if you go to the AMOS site

(obesityhelp.com/morbidobesity) there is a tool to calculate your

BMI. Good Luck!!!!

Hello to the rest of the group, I've been reading for awhile, but

this is my first post. I've really learned a lot from all of you,

and am more convinced that the DS is the best way to go. :-)

Diane from Idaho

---Hoping to be switched soooon!

---PreOp Wt.320(BMI 62)

---Remember God loves U!

---Be Blessed

---<>< <><

--- luvgranny@...

[Guest guest]

How could your doc think that your BMI is only 53? I weigh 350 and am 5

feet tall. My BMI is 67 - 68. Go to any search engine and search for body

mass index calculator and you will pull up several " calculators " that you

can put in your information and it will figure your BMI for you. I'll bet

all of them put your's in the high 60's. Some doctors recommend the DS for

super or malignant morbidly obese patients. Good Luck!

Jerry, still fighting for approval in Louisiana

>

>Reply-To: duodenalswitch

>To: <duodenalswitch >

>Subject: Re: Re: Insurance approval for DS

>Date: Sat, 29 Sep 2001 13:08:02 -0700

>

>Thank you for all of your messages. I have a lot of homework to do in my

>quest for a second review of my case with Health Net.

>

>I weigh 369 lbs at 5'1 1/2 " with a BMI that I calculate in the mid 60's

>(although my physician says it is only 53...which would be at least

>slightly

>better if he is correct.) My goal in having the DS is that I want to lose

>adequate weight... and once having lost it, to keep it off. I also don't

>want the " dumping " syndrome... and I want to live as near a normal life as

>possible with my friends and family (like eating a near-normal meal).

>

>My Dr. is supportive of the DS procedure, but his Medical group is not...

>and neither is Health Net. They insist that the only course of action for

>me is an RNY. I have been told verbally by Health Net that I only have one

>appeal process left... which is to a committee called the DMHC? Anyway, I

>want to have my ducks in a row with this appeal.

>

>Elle Rowley

>

> Re: Insurance approval for DS

>

>

> > Hi Elle,

> >

> > I just reponded to your post in DS_Insurance_Authorization before I

> > saw this one.

> >

> > Regarding the DS being " experimental " or " investigational " , I have

> > devoted the better part of the last three months doing research that

> > debunks this myth. You will find it on :

> >

> > http://groups.yahoo.com/group/duodenalswitch/files/

> >

> > go to " Hull's folder "

> >

> > and look at the file: aetna letter.doc

> >

> > 51 journal papers are referenced, and I have copies of about 30 of

> > them (the others I had the abstracts only).

> >

> > Hull

> >

> >

> >

> > > I am trying to get approval from Health Net (California) for a DS

> > > surgery; however, they say that the DS is an " experimental "

> > surgery.

> > > If you have specific information (like a research paper published

> > in

> > > a medical journal) which would support my position with Health Net,

> > > please send me info on where I can obtain it. Or... better yet, if

> > > Health Net PAID for your surgery, please let me know. I know they

> > > have paid for some people for the DS surgery... and I am trying to

> > > gather some backup that they have already paid for this surgery. I

> > > believe it is about money, rather than that they are thinking of my

> > > health Thank you in advance... Elle Rowley

> >

> >

> > ----------------------------------------------------------------------

> >