Question regarding not having documentation of pass ettempts of weight loss

[Guest guest]

Did anyone have this problem? Most of my ettempts have been Weight watchers,

diet books on my own, calorie reduction on my own...

What am I going to do? My insurance company wants 3 years of documented weight

loss ettempts and I know I don't have them. My ettempts have mostly been on my

own.

Did anyone come across this road block before?

[Guest guest]

,

I did not have anything either. I went to WW a dozen or more times, but they do

not keep your records unless you are a lifetime member. I had been to

Nutri-Systems so long ago I couldn't find anything from that. I just sat down

and tried to list every diet I have been on and recreate my diet history. I

also had my doctor list my weights at different times and the fact that he

documented that I had been to WW.

Hopefully you can do like I did and recreate them. It is just another hurdle

that they put up there to try and dissuade you from trying. Did your doctor

ever suggest that you go on a diet and document that you did in your records?

You just have to learn to be inventive. Good luck.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

[Guest guest]

> Did anyone have this problem? Most of my ettempts have been Weight

watchers, diet books on my own, calorie reduction on my own...

>

> What am I going to do? My insurance company wants 3 years of

documented weight loss ettempts and I know I don't have them. My

ettempts have mostly been on my own.

>

> Did anyone come across this road block before?

>

Hi ,

Yes, my insurance kept denying me and I kept appealing to the point

that they finally asked me for 5 years of documentation. Since I was

diagnosed with diabetes 6 years ago I saw nutritionists then and kept

food logs every day for the past 6 years. I also got copies of all my

medical records from my primary care physician, cardiologist and

gynecologist, and dietitian visits. I made xerox copies of all my

medical records and every place that weight was mentioned in any way I

drew an arrow in the margin noting it.

I had also made many dietary purchases online so I had documentation

from those sites. Good reason to buy from Atkins online.

In the end I submitted a 623 page appeal document to appeal the 5th

denial. It took me 9 months but I finally won a partial victory. I

had wanted a Deuodenal Switch but they only would approve for the RNY.

I wanted a specific surgeon and hospital so I took the RNY and had

surgery last month on 7/26/04. I have lost 40 pounds which for me is

25% of my excess body weight. I used those 9 months to learn as much

as I could about the way to make weight loss surgery work. There are

lots of people who think you don't have to work at it and some people

think that they will never have to diet again. They may regain the

weight they lose initially. It happens if you go back to your old

ways. I have made the mental adjustment that the RNY is only a tool

and I am responsible for the hard part, keeping the weight off once I

reach my goal weight.

I want to encourage you to use your diet history as an outline and try

to document everything possible. If you are young enough to consider

investing in a routine that will guarantee a paper trail I suggest you

do that. If you don't and you are not granted insurance coverage and

you can't afford to self pay you will be no better off in three years

than you are today...except if you begin collecting a history of a

" medically supervised diet " now you can use that documentation in

three years.

I was not young enough for that since I'm 61 and would be ineligible

in three years.

Don't waste time. If you are granted coverage you have lost nothing

and maybe learned more about how your body works along the way.

Best of luck. Don't ever give up.

Cathy

RNY 7/26/04

- 25% of excess body weight

[Guest guest]

HI ELIZABETH

I HAD THE SAME PROBLEM WITH MY INSUFRANCE COMPANY AS WELL. I THOUGHT

THAT BECAUSE I HAD BEEN DOING WEIGHT WATCHERS FOR A COUPLE OF YEARS

THAT WOULD WOULD COUNT BUT MY INSURANCE (BLUE CARE NETWORK) SAID THAT

IT HAD TO BE SOMETHING THAT WAS DOCUMENTED BY MY PCP(PRIMARY CARE

PHYSICIAN) I TOLD THEM THAT IF I WENT TO THE DOCTOR EVERYTIME I

WANTED TO TRY A NEW DIET THEN I MIGHT AS WELL MOVE IN THERE. I WAS

DENIED 3 TIMES AND THEN THEY SAID I COULD DO A LEVEL 4 APPEAL AND

THAT IS WHERE I WOULD MEET WITH DR'S ON THE INSURANCE BOARD OR

WHOEVER IT IS THAT MAKES THE DECESSIONS TO APPROVE OR NOT.I FIGURED

WHAT DID I HAVE TO LOSE I HAD ALREADY BEEN DENIED 3 TIMES. I DID MINE

OVER THE PHONE AND I EXPLAINED EVERYTING 2 THEM. THE DOCTOR THERE DID

ASK ME WHY I STOPPED DOING WEIGHT WATCHERS AND I TOLD THAT IS WAS DO

TO FINACIAL REASONS PLUS WHEN I WAS DOING IT IT WAS THROUGH MY JOB

AND WE WOULD HAVE THE WW MEETINGS ON HOUR LUNCH BREAK AND IT MADE IT

EASIER BECAUSE WE WERE ALL IN IT TOGETHER AND WHEN I WAS ASKED IF

MONEY WAS NOT AN ISSUE WOULD I RECONSIDER DOING WW AGAIN. I TOLD THEM

NO BECAUSE I COULD FALL OFF THE WAGON AND IF I HAD THE WLS THEN I

WOULD NOT HAVE A CHOICE BUT TO FOLLOW WHAT I HAVE TO DO. I WAS AMAZED

THE PHONE CONFERENCE TOOK LESS THAN 20 MINS AND I RECEIVED MY

APPROVAL LESS THAN 1 WEEK LATER. THAT WAS LAST SEPT. AND I HAD MY WLS

OCT 28 2003. SO FAR I HAVE LOST 99LBS (WISH IT WAS MORE, BUT EVERYONE

SAYS I LOOK GOOD AND I HAVE NOT BEEN IN THE 100'S FOR ABOUT 10 YEARS)

BUT ANYWAY. GOOD LUCK WITH YOUR DOCUMENTATION. AND DONT GIVE UP

NORA WILLIAMS

292/191/160

MICHIGAN

> > Did anyone have this problem? Most of my ettempts have been

Weight

> watchers, diet books on my own, calorie reduction on my own...

> >

> > What am I going to do? My insurance company wants 3 years of

> documented weight loss ettempts and I know I don't have them. My

> ettempts have mostly been on my own.

> >

> > Did anyone come across this road block before?

> >

>

> Hi ,

> Yes, my insurance kept denying me and I kept appealing to the point

> that they finally asked me for 5 years of documentation. Since I

was

> diagnosed with diabetes 6 years ago I saw nutritionists then and

kept

> food logs every day for the past 6 years. I also got copies of all

my

> medical records from my primary care physician, cardiologist and

> gynecologist, and dietitian visits. I made xerox copies of all my

> medical records and every place that weight was mentioned in any

way I

> drew an arrow in the margin noting it.

>

> I had also made many dietary purchases online so I had documentation

> from those sites. Good reason to buy from Atkins online.

>

> In the end I submitted a 623 page appeal document to appeal the 5th

> denial. It took me 9 months but I finally won a partial victory. I

> had wanted a Deuodenal Switch but they only would approve for the

RNY.

> I wanted a specific surgeon and hospital so I took the RNY and had

> surgery last month on 7/26/04. I have lost 40 pounds which for me

is

> 25% of my excess body weight. I used those 9 months to learn as

much

> as I could about the way to make weight loss surgery work. There

are

> lots of people who think you don't have to work at it and some

people

> think that they will never have to diet again. They may regain the

> weight they lose initially. It happens if you go back to your old

> ways. I have made the mental adjustment that the RNY is only a tool

> and I am responsible for the hard part, keeping the weight off once

I

> reach my goal weight.

>

> I want to encourage you to use your diet history as an outline and

try

> to document everything possible. If you are young enough to

consider

> investing in a routine that will guarantee a paper trail I suggest

you

> do that. If you don't and you are not granted insurance coverage

and

> you can't afford to self pay you will be no better off in three

years

> than you are today...except if you begin collecting a history of a

> " medically supervised diet " now you can use that documentation in

> three years.

>

> I was not young enough for that since I'm 61 and would be ineligible

> in three years.

>

> Don't waste time. If you are granted coverage you have lost nothing

> and maybe learned more about how your body works along the way.

>

> Best of luck. Don't ever give up.

> Cathy

> RNY 7/26/04

> - 25% of excess body weight