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

Insurance wants to call to get my weight before my surgery....is this a catch?



Recommended Posts

I have BCBSKS and got an approval a couple of weeks ago. Then a nurse from BCBS called me and said that in a few weeks they would "interview me" in which i would give them my height and weight. I have lost about 9 lbs since my last class for the approval process and am afraid they will find ways to deny me this late in the game. I already have a surgery date ready to go but also know insurance have done last minute denials to people in the past.

Do any of you have experience with that and if so - should I be worried? Thanks.

Share this post


Link to post
Share on other sites

every Insurance has a cut off line for the surgery based on weight and other health issues you have if you are right up against that line you could get denied but if you are way over or have plenty of other weight dependent health issues it is just a formality they go thru

Share this post


Link to post
Share on other sites

Generally speaking (your insurance may vary!), your weight immediately prior to surgery indicate 2 things:

1: weight loss since your initial consultation with the surgeon

2: BMI > 40 (without comorbidities) or BMI > 35 (if you have at least one or 1 qualifying comorbidities such as severe sleep apnea, type 2 diabetes, etc)

Share this post


Link to post
Share on other sites

What are the exact criteria on your insurance plan for surgery? Check the policy. Email from their online sight and ask what would deny surgery, ask specific questions - 'if the bmi is 39 and no comorbidities, ' if I gain or lose any weight in the process', 'if already approved and scheduled, what would cause a denial?' I say use email rather than phone because there will be a written record.

BUT first, call your surgeon's office and speak to the insurance specialist - that person has experience with your ins company firsthand and would know about this 'nurse-phone call' thing.

I wish you luck and success.

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

    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 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

    ×