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I already introduced myself and explained that I went to a WLS seminar and they sent my records and primary dr.letter into my insurance company to see if I could be approved for treatment (i.e., surgery as outlined in my dr. referral letter).

I received the letter about a week after the records were submitted and am waiting to hear back from the WLS place for moving forward with the other steps of meeting with the dr. etc.

After reading several posts it sounds like most people had a surgery scheduled before they got their approval letter? Why did I get approved so early in the process?

Not complaining, wondering if this is "too good to be true"...

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I didn't get my surgery date until after my insurance company approved the surgery, but each insurance company is different. My insurance also required a 3 months supervised diet even though my BMI puts me well above the norm. That being said, once my doctors office submitted my paperwork, I was approved in a week.

Good luck, it sounds like you're on the fast-track!!

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Yeah that is what I was thinking...I previously had Blue Care Network and they required 6 months of supervised dieting by your primary. I completed 4 months and then we moved 20 minutes from where we currently lived and my insurance switched to PHP-Mid Michigan. Their requirement was only 12 weeks of supervised dieting which I had already completed within the last year under the old insurance plan. I meet all the other requirements (bmi of 45, sleep apnea, hypothyroidism, borderline diabetic, pcos). I am also wondering if I was quickly approved because the bariatric center of excellence I went to is run by the same hospital (sparrow) that runs PHP of Mid Michigan. Who knows.

At any rate, I am glad to hear it sounds like my letter is the real thing! I am hoping that the fact that my gallbladder has already been removed and I have already had a sleep study in the past year and have and use my apnea mask that this will also speed things up.

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I received my approval Letter about a week after my Surgery. I guess the Surgical Center you choose for surgery know what Insurance carrier will prolong there approval and who doesn't:biggrin:

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My Ins requires 3 doctor visits and I have to show I am willing to change my lifestyle.

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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

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