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Why not insurance approval prior?

I guess I must be slow at catching on. Lol....I can't figure out why they do all the testing prior to getting surgery approval. You can go through all the tests and then not be approved. Then you have a bunch of medical bills you have to pay for nothing. Begining to wonder if it's a way for the doctor to make money whether you have surgery or not....Any ideas? Any one else wonder this?

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Well it was my insurance company that made me jump through hoops. The insurance company lets you know if you qualify with your BMI and/or health issues and then final qualifying if you follow their testing.

My first choice doctor did the same. Had me schedule a visit with the cardiologists, shrink and labs. I called back to tell them I wanted to wait till I had insurance approval and what will insurance cover. I eventually dropped that doctor and glad I did. Didn't stop him from sending a $500 bill for one 10 minute consultation that my insurance did pay for.

I can see many patients go into some of these surgery mills and just get rolled over by all the medical jargon and starry eyed fantasies of being thin. And then the bills start rolling in.

Yup! Some doctors and their office just don't care and neither do the staff. On the other hand, it could stop a lot of morbidly obese people from having their surgery and achieving a healthier life. Don't know if it worse to bully people into spending the dollars or letting them go on with their sad unhealthy lifestyle? Heaven knows how many times I've heard myself and others on this forum look for excuses not to follow through with the plan?

tmf

Insurance should pay if they require the test. They even payed for my tests, and I paid the surgery.

  • Author

Thanks for the info. My BMI is 40. I don't have any other health issues. I can just see me making a bunch of 80 miles round trips for all these tests and then my insurance denying me for some reason. How disappointing that would be.

Thanks for the info. My BMI is 40. I don't have any other health issues. I can just see me making a bunch of 80 miles round trips for all these tests and then my insurance denying me for some reason. How disappointing that would be.

That's where you talk with the bariatric surgeons office and let them tell you if you qualify.

My ppl told me, no problem.

Best Wishes!

In My experience, the insurance would not even take the paperwork for consideration of the surgery until all of the pre-op stuff was complete. Those tests, etc is what they base their decision off of. I went through 3 insurance companies before I got approved...let me tell you, it was an emotional process!

In My experience, the insurance would not even take the paperwork for consideration of the surgery until all of the pre-op stuff was complete. Those tests, etc is what they base their decision off of. I went through 3 insurance companies before I got approved...let me tell you, it was an emotional process!

In My experience, the insurance would not even take the paperwork for consideration of the surgery until all of the pre-op stuff was complete. Those tests, etc is what they base their decision off of. I went through 3 insurance companies before I got approved...let me tell you, it was an emotional process!

You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

tmf

You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

tmf

That's what I did. I contacted my insurance company and they sent me the criteria for what my weight, health issues and testing I had to do. My Bariatric office also got that from my insurance company. So insurance Company approved my going forward and then all the paperwork was sent in for final approval and my insurance company paid for all the testing.

Just an after thought

I was really happy that I had to go through all this testing because it gave me time to learn all I could about LBS and I believe it put me in a better position to succeed.

Thanks to everyone on LBT.Com I had the best on-line education!

  • Author

You make a good point. I think it would be helpful for the poster to research if her insurance will pay for bariatric surgery in the first place. Then move forward with the tests etc.

tmf

I contacted them. It is covered if your BMI of over 40 (which I am) or over 35 with comorbidities. I am just nervous that something is going to happen. Sorry, I'm just always "Nervous Nellie"....

I contacted them. It is covered if your BMI of over 40 (which I am) or over 35 with comorbidities. I am just nervous that something is going to happen. Sorry, I'm just always "Nervous Nellie"....

You're ok, it's better to ask questions than going in blind.

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