Jennie1980
Active Member
- Joined
- Apr 21, 2016
- Messages
- 35
My insurance is BlueCare TennCare, Tennessee's medicaid. Actually it's my secondary. My primary excludes. Next week is my 5th supervised diet visit with my PCP. I've completed everything else. I meet all of their criteria except the need for the 5 year weight history showing morbid obesity.
I gained more weight after having thyroid disease. That pushed me to 35.3 BMI. Well that and other things. I've never been thin but it's been a long time since I've been as heavy as I am. 5.3, 199lbs.
I'm seeing Dr. Boyce in Knoxville TN. His office person is pissing me off.
I just found this 5 year requirement. I have contacted the office and told them more than once that my PCP doesn't speak English as a first language and communicating insure required verbage is like pulling teeth. I asked the authorization person to look over a recommendation and clearance letter that I've written for my PCP to put on letterhead and sign.
Instead of responding to me, they faxed my PCP a template. So I called them and explained the language barrier again. Discussed the five years of morbid obesity history. I was told we will submit and see. I'm not ok with that. She said the PCP can be very basic blah blah.
I disagree that basic will help a thing. I'm going to need a really strong letter to hopefully over power this one issue.
I'm sick. I'm in pain. I don't have time for an absolutely unnecessary fight if an appropriate letter can prevent that. She doesn't appear to give a shit.
May be important to add that I can switch to United Health Care on July1. Apparently they're much easier to deal with. But if this is a TennCare rule, doesn't matter which insurance provider I have through them???? I will post my letter below. I'll be happy to answer or clarify anything. I'd appreciate any and all thoughts on any of this.
I gained more weight after having thyroid disease. That pushed me to 35.3 BMI. Well that and other things. I've never been thin but it's been a long time since I've been as heavy as I am. 5.3, 199lbs.
I'm seeing Dr. Boyce in Knoxville TN. His office person is pissing me off.
I just found this 5 year requirement. I have contacted the office and told them more than once that my PCP doesn't speak English as a first language and communicating insure required verbage is like pulling teeth. I asked the authorization person to look over a recommendation and clearance letter that I've written for my PCP to put on letterhead and sign.
Instead of responding to me, they faxed my PCP a template. So I called them and explained the language barrier again. Discussed the five years of morbid obesity history. I was told we will submit and see. I'm not ok with that. She said the PCP can be very basic blah blah.
I disagree that basic will help a thing. I'm going to need a really strong letter to hopefully over power this one issue.
I'm sick. I'm in pain. I don't have time for an absolutely unnecessary fight if an appropriate letter can prevent that. She doesn't appear to give a shit.
May be important to add that I can switch to United Health Care on July1. Apparently they're much easier to deal with. But if this is a TennCare rule, doesn't matter which insurance provider I have through them???? I will post my letter below. I'll be happy to answer or clarify anything. I'd appreciate any and all thoughts on any of this.