jayeedee

I've never heard of sleep apnea being a requirement to being approved. Plus I remember from one of your earlier posts that your insurance company didn't even require a sleep study so how could you be denied based on something they don't think that you need to find out if you have.

I would tell your surgeon to go ahead and submit.

Ack. I feel like a pest each time I have to contact them. I told them to submit. I am not sure what the sleep hangup is... not sure if it is normal :/

My insurance has very few pre-approval reqs. I just need a nutrition clearance, psych clearance, and labs/upper GI... all completed last week, all cleared the beginning of this week. My surgeons office is saying that I will probably be denied though because I don't have sleep apnea. The hypertension, asthma, GERD and reflux are apparently not enough? Has anyone had this happen? I am trying to stay calm due to the hypertension stuff, but it is to the point where they are saying they don't even want to submit to insurance despite having the all clear on all the tests etc.

Has anyone been approved despite not having sleep apnea? Should I push the surgeons office to submit to insurance any way? I don't want to make our relationship bad but I also want to see this through, even if I end up with a denial.

Thanks for all the replies everyone. I'm not against the sleep study, just the way this was all organized. I found an actual sleep center, on that is recognized by the AASM, that can see me next week. Like I said, I don't want to just have a one off doctor's appointment. I am trying to let these appointments be the first step in establishing relationships with doctor's and clinics I can continue to go to post surgery in the event I have any problems.

I am going to see how the next few appointments go with the doc before I make a final decision on switching or not.

In my case, it was an insurance co. requirement.

This is definitely not an insurance requirement for me (checked with the insurance company). I asked the office and they said this is being requested by them. I just looked up the whois of the parked domain the emails are coming from from the sleep center are coming from and it looks like it is owned by the surgeons office so... yea. Not so comfortable with all of this.

I will probably call tomorrow to see if I can get a referral to an actual sleep specialist and do the testing at one of the sleep centers recommended by The American Academy of Sleep Medicine and maybe begin seeing about switching surgeons too, just in case the timeline seems undoable with the surgeon I am currently seeing.

Needless to say, anyone successfully switched?

Hi Everyone,

Nice to meet you. I had a question about switching doctors.

The background:

I am working on something of a compressed timeline, but it was doable. I had never thought about weightloss surgery until my BP skyrocketed and my PCP was hesitant to put me on medication due to my age. However, my metabolism died post children, and to lose weight I apparently need to eat 1000 calories or less a day to bring my weight down, something that is not sustainable for me without surgery. Without staying at that level, my body is happy between 235-245... but then the BP thing happened. I went to a seminar, the initial appointment with my surgeons office and found out everything I needed to do before going in to surgery for the insurance and for the doctors office. I had two weeks set aside where my schedule was mostly open to take care of all the appointments that were needed. On Friday the surgeon's office called and said that they want me to have a sleep study, something that was not mentioned in the original meeting. I have never had sleep problems, not a snorer, I have one of those fancy sleep bracelets to monitor my sleep cycles and I sleep perfectly well through the night, and all my weight is in my hips, thighs and butt so this was surprising to me, especially since it wasn't mentioned when I went to the appointment and asked about all of this over two weeks ago.

I am a bit uncomfortable with all of this as I can find nothing on the sleep center that they recommended except a Facebook page with 2 likes. Also, if I have to go to a sleep center, I would like to speak with a sleep specialist. I am trying to form a team I can go to if I have problems post surgery. That is what I based my per-approval nutritionist and psychologist on. This sleep center seems to be only associated with practice and I am not finding anything about an affiliated MD that deals with sleep disorders. Further, I don't have a flexible schedule due to work and school, and the sleep center they referred me to is not very flexible or open with the times I can come in and they require three weeks per the message I received to analyze the data they collect. Right now the earliest appointment is 3 weeks out, and that pushes all of this past the original timeline I went over with the surgeons office and makes it so there is a chance I won't be able to have surgery until March, when I have my next break. Needless to say, if I have to do the sleep thing, I would rather go somewhere else, and would really prefer to go to an MD to discuss everything. Honestly though, if my insurance doesn't require it, I am also a bit upset that this happened without consulting with me first since it is another thing that will be billed to insurance. In the event that there is no way around going to this specific sleep center with this doctor, I might need to change surgeons or go without the surgery until March and get on BP medicine

The Question:

Has anyone managed to change their surgeons once they received approval from their insurance? I'm done with all my pre-approval requirements, so I am now just waiting to hear back.

Thanks for any input you can provide.