Thanks Dawn and Chris

[Guest guest]

" Remember to keep your conversations to approval or not based on the

letter. I would not go discussing the procedure with them at all. Let the

doctor talk in medical terms to them (in the letter). "

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I second what Dawn says here. My surgeon (Dr. Anthone) wrote the DS

up as a distal roux-en-Y with gastrectomy. It is technically almost

correct. My " approval " letter lists that the requested surgery is

approved and then on the same page states that the DS will not be

covered (I have Aetna). If I made the mistake of mentioning that I

was getting the DS, I could have blown Dr. A's cover (so to speak).

Let your surgeon handle things at least for the first round. Refer

to you surgery in vauge terms that are non-medical or let them call

it a " gastric bypass " (though it is not). Make sure that the paper

gets from Dept. A to Dept. B intact. I lost a month because my

request was " lost " between departments (alegedly).

Hull

Thanks Dawn and Chris. good point and good warning. My letter is very

similar to Dr. Anthone's. It says Gastric Bypass with Long Limb roux-en-y

with cholecystectomy.

Thanks also for the heads up on checking that the letter gets to the correct

dept.

I am most concerned that they will say I have a pre-existing condition, even

tho when I called for info about this they said it refers to any chronic

condition for which I received treatment in the previous 6 months before

becoming insured, and I didn't go to a Dr. for any condition in the previous

6 months except bronchitis. But how can you require bariatric surgery

without having been fat for more than 6 months?

I just hope they will ok it.

By the way, I am still quitting smoking - haven't had a cigarettes since last

Sunday (2 weeks tomorrow).

Carole