Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Getting Approved By Insurance



Recommended Posts

Anyone have any tips on ensuring insurance approval? I meet all the criteria but have oftened wondered if during the monthly check ups with your doctor you are brutally honest and say "no, I haven't worked out like I should?" if that will affect approval. Does the insurance company say..."this person hasn't done what they have been asked to do."

Or should I just go and tell my doctor exactly what they want to hear..."oh yeah, doing exactly what is asked of me....all day,....everyday."

Which we all know is not true but I have tried to lose weight for YEARS and now I am just going through the motions to get approved.

Thoughts, suggestions?

Share this post


Link to post
Share on other sites

This going to be interesting I was thinking the same thing ... My doc ask me have I done weight watchers . South beach ect .. I said no but I have been on diets where medication was prescribed but i wonder if not had done all those other ones will it matter

Share this post


Link to post
Share on other sites

Your surgeon's office is the entity that submits your paperwork to insurance. It is in their best interest to present your case in the most favorable way in order to insure approval. They don't get paid for doing the surgery if the surgery is not done. That being said, I honestly believe they do everything possible to make sure you get approved on the first submission. Failing to do so just creates more work for them and the doctor if peer to peer review is involved.

Share this post


Link to post
Share on other sites

I think the only thing you can really do to assist in getting approved is to try to do what they recommend. I had no faith that I would be approved but my nut assured me that I would be. She said I didn't gain weight and I did all of the required tests. In her office, she said she had never seen anyone denied who had done those things. Hey, I was approved!

Share this post


Link to post
Share on other sites

I asked my nutritionist this exact thing the last time we met. She told me that insurance company just wants to be able to check the box that you met the requirement. They don't care about the results. She told me that some people really need it because they had no idea what a proper diet should look like. For others, like me, she doesn't have much to tell me past the 1st session. She'd be happy with me losing 1 pound a month for a total of 6 pounds but the insurance company doesn't care.

Share this post


Link to post
Share on other sites

All depends on the insurance company because I've read on a forum where someone was denied for being noncompliant with the 6 month diet.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×