Laura Lopez 20 Posted February 6, 2016 Today was my 3rd consult out 6 with my bariatric surgeon. I was asking the receptionist there about the whole process to getting approved for surgery. When she starts to review my medical file, she noticed that out the 2 year weight history they requested, one of them is not very detailed but it does show my weight then, (and was definitely overweight) and the other report has a note from the dr stating her concerns for my weight. Long story short, I may get denied because one of my weight history is not as detailed. And to top it all off she said that my insurance has been very picky lately. ???? feeling a bit down. Share this post Link to post Share on other sites
Cervidae 2,389 Posted February 6, 2016 my advice would be not to get discouraged before you even know if anything's going wrong. Just giving yourself anxiety and sadness with no cause and no solution. Who knows, it's entirely possible it will go through without a hitch. Or possible that if you get denied, your surgeon can appeal and their appeal will be enough. There's always a way. Share this post Link to post Share on other sites
James Marusek 5,244 Posted February 6, 2016 Many insurance companies require more than a weight history. They require that the patient takes action to try and reduce their weight through exercise and diet and was unsuccessful. And that this process is well documented. Many look at the patients BMI and the amount of obesity and also their co-morbidities. In many cases the insurance requires that the patient undergo a 6 month medically supervised weight loss program that includes diet and exercise. In many cases this is significantly stricter than provided by a general practitioner. But these requirements can vary from one insurance to the next. It is probably a good idea to begin attending Bariatric Surgery Support Group meetings. They are generally held monthly and are generally free. Share this post Link to post Share on other sites
B-52 7,113 Posted February 7, 2016 Many insurance companies require more than a weight history. They require that the patient takes action to try and reduce their weight through exercise and diet and was unsuccessful. And that this process is well documented. Many look at the patients BMI and the amount of obesity and also their co-morbidities. In many cases the insurance requires that the patient undergo a 6 month medically supervised weight loss program that includes diet and exercise. In many cases this is significantly stricter than provided by a general practitioner. But these requirements can vary from one insurance to the next. It is probably a good idea to begin attending Bariatric Surgery Support Group meetings. They are generally held monthly and are generally free. Same here....I had to undergo a 6 month medically supervised diet, complete with weekly progress notes, charts, graphs, etc. I told the weight loss center that I have done diets time and time again....why another one? They said the insurance co. wants it OFFICIALLY on file, signed off from a Dr., showig I did a sincere diet, and FAILED. They will not simply take my word for it. So yes, I took the 6-month program, at great expense to me out of pocket. And just like every other diet I started out good, lost significant weight, then started to cheat and rationalize, then start to gain it all back...in other words, I failed miserably....but this time it was official, on record for the insurance co. I have read here over the years about people saying the insurance co. demands they be successful with this diet or they would not approve surgery.... To me that's confusing...if I could be successful at diets, then why would I need - want Weight loss surgery? Share this post Link to post Share on other sites
Dub 9,922 Posted February 7, 2016 I will not even begin to attempt to address the ways in which insurance companies can aggravate you to no end. My only advice regarding them is to contact the bariatric administrator employed by your insurance company.....review your case in detail with them and make sure that YOU are driving that bus. Don't assume your surgeon's staff has everything laid out for you. My only other pieces of advice are to relax and to begin losing today....don't wait until the surgery to lose weight.....begin getting it off right away. The goal is to lose weight.....not to wait around, right ? I promise you that the discipline you demonstrate now will be rewarded and will pave the way to very good initial results when you have your surgery. Share this post Link to post Share on other sites