reese711 8 Posted March 8, 2017 So I got my second denial last week because 1. They need proof my obesity is not endocrine related, easy enough. I just had normal thyroid levels drawn last month. My swallow test showed mild gerd and they want that treated. Also easy, my pcp called in a script. My first denial was because I hadn't participated in the 6 month weight loss program and had not done upper gi testing. My insurance coordinator calls me today and says I need to re do the 6 month program because in the 3rd month I gained 2 lbs. overall I lost 14 lbs from initial weigh in to my 6th appointment. Anyone else have this happen to them?!?! Share this post Link to post Share on other sites
NJ12 6 Posted March 8, 2017 I did not but in my support group we have 2 people on hold because they were told to lose 20 to 50 pounds before the office will put through there paper work for approval. Insurance requirements are changing and I believe it will only get worse. Good luck to you. Share this post Link to post Share on other sites
Proud2BMe 1,016 Posted March 9, 2017 Sorry, that's the price you have to pay when you are wanting insurance to pay for it. You will have to jump through all the hoops. And there is a good reason for this. They want to weed out the people who are not good candidates because they are not willing to do the work that is needed to lose the weight. That's the hard truth. Many people simply do not make good bariatric patients because they have no real drive or motivation to lose weight and make the surgery a success. My own personal opinion is that self-payers tend to be more successful because they have to be truly motivated from the get go because we have to pay for everything ourselves. Then again, we don't have to jump through any hoops for our surgery. 1 OutsideMatchInside reacted to this Share this post Link to post Share on other sites
reese711 8 Posted March 9, 2017 I'm just going to do two more months so that it shows 0 weight gain the entire 6 months. I don't want them to have any reason to deny me again. At this point I've been jumping through hoops for 7-8 months there is no way I'm stopping now. Over 2000$ in and down 22 lbs as of this morning. Not happening. I'm determined to get this approval!!!! Share this post Link to post Share on other sites
hmills653 365 Posted March 17, 2017 I'm a little concerned about the cost as well. My insurance pays 90% after I meet my deductible of $3100. Since I'm nowhere near this I'm hoping for the best. I do have an HSA. But I had so many medical expenses last year the money going in this year has still been paying me back from last year's claims lol. Share this post Link to post Share on other sites
