Final pre-op requirement done!

[KelseyBennett_vsg 28]

It's been a couple of weeks since I posted, so here's my update. I finally got all of my weight loss study paperwork sent to my surgeon and they told me to go have my blood work re-done before they would submit to insurance, just to be safe. I went and had that done yesterday (they got it on the first stick!), they said it would just be a couple of days then they will fax to surgeon! I'm so nervous about insurance approval now it's ridiculous. I'm terrified they will deny me again bc I only maintained on the study, the weight just wouldn't come off. I would weigh in the morning and have lost 7 lbs, then by my afternoon appt it would all be back even if I didn't eat ???????? I'm so close now, I just can't give up! Anyone else have crazy nerves about insurance approval? I think this is the worst part for me.

Sent from my SM-T530NU using the BariatricPal App

[KristenLe 5,979]

@ Were you previously denied? I can't imagine you will have difficulty getting approved. I was nervous and there was no need to be. I called the week after it was submitted and the insurance coordinator at my surgeon's office said "oh yeah - that was approved right away". I suggest you check back in with them in the next couple of days to make sure it got submitted and to find out a status. Don't hesitate to call insurance and ask them too.

Fingers crossed!

[KelseyBennett_vsg 28]

Yes, I was denied in November bc my surgeons office didnt know I needed the 6 month Dr guided weight loss study. They assumed I didn't bc generic BCBSIL doesn't need one, but my Dad's employers specific plan does. It was kind of a nightmare to get everything done in a month, just to be denied bc of no fault of my own. But, I've got everything done now, and am quickly moving forward. I'm hoping it's a quick approval bc I'm 25 with a 63 BMI. It's been a rough road but I can see the end!

Ready to really start living! ????

[cindym44 75]

Get the guidelines from your insurance company and read them. Have you completed everything that your insurance company requires? Are your 6 months of a structured diet program documented correctly? Does your insurance require that you lose 5% on the weight loss program? Some do, some do not. Have you completed your psych exam and nutritional appointments? Most insurance companies require a psychological exam plus visits to a nutritionist. Is your surgeon requiring that you attend a support group before surgery? Best thing is to read the insurance requirements and talk to your surgeon's assistant if you have any questions. Hopefully your surgeon's assistant is now doing her homework too - obviously they didn't do it before they submitted the first time. My surgeon's assistant has NEVER had a patient denied. Good Luck.

[KelseyBennett_vsg 28]

I've done the psych evaluation, the support group, the sleep study, the 6 months were all documented properly. The blood work I already had done, but it had been a year, so they wanted that done again before they would send off again. I completed everything in November of last year and got denied due to needing the weight loss study. My surgeons office assumed I didn't need it instead of actually verifying.

My insurance company will not send requirements and guidelines to patients, I tried to get them last year when I first started my journey. They said that they only send them to doctors "because they are very technical and most people wouldn't understand them anyway". So I'm just kind of in limbo on that. I don't know what my insurance exactly requires and have just had to take my Pcp's advice on what he has had other patients do to get approved. My surgeons office is actually less than helpful, but they are the best in my state, so I'm trusting them to get me through this.

Ready for a chance at really living! ❤️