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May Not Be Approved! WHAT?

sunnyd

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sunnyd    32

sunnyd
Posted

SO I finally finish all my requirements after many months of appointments and as the doctor's office is getting ready to submit my paperwork to insurance- they say I may not be approved because I don't have 3 consecutive years proving my weight/BMI. Ok so I have a high BMI documented in 2008, 2010, and 2011. For some odd reason I never went to the doctor in 2009 and therefore do not have my weight recorded for that year- and because of this I may not be approved. I would have to wait a whole year to try again if it is denied for that reason. I had wanted to wait until June/July to have the surgery but due to my endoscopy showing ulcers and hernia the surgeon wanted it rushed and told me I shouldn't wait that long- but now I may have to wait a year. What? AAUUGGHH! I'm going crazy!!!

Do they really think I had a high weight/BMI in 2008 but lost a ton of weight in 2009 and not have a high BMI and then have a high weight/BMI again in 2010. Come on- really?

Anybody have a similar situation or any advice???

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klus263    9

klus263
Posted

SO I finally finish all my requirements after many months of appointments and as the doctor's office is getting ready to submit my paperwork to insurance- they say I may not be approved because I don't have 3 consecutive years proving my weight/BMI. Ok so I have a high BMI documented in 2008, 2010, and 2011. For some odd reason I never went to the doctor in 2009 and therefore do not have my weight recorded for that year- and because of this I may not be approved. I would have to wait a whole year to try again if it is denied for that reason. I had wanted to wait until June/July to have the surgery but due to my endoscopy showing ulcers and hernia the surgeon wanted it rushed and told me I shouldn't wait that long- but now I may have to wait a year. What? AAUUGGHH! I'm going crazy!!!

Do they really think I had a high weight/BMI in 2008 but lost a ton of weight in 2009 and not have a high BMI and then have a high weight/BMI again in 2010. Come on- really?

Anybody have a similar situation or any advice???

My insurance only required 2 years. Call your insurance company and check to see what their requirements are.

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Bemabound    11

Bemabound
Posted

Hi, We have Cigna and for us it is also 2 years BUT my surgeons off said it can be from ANY dr...doesn't hve to be the same dr every year...so GYN, or PCP or any! Even an Urgent care maybe? Hope this helps....ask your place if this would work! Tracy

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sunnyd    32

sunnyd
Posted

SO I finally finish all my requirements after many months of appointments and as the doctor's office is getting ready to submit my paperwork to insurance- they say I may not be approved because I don't have 3 consecutive years proving my weight/BMI. Ok so I have a high BMI documented in 2008, 2010, and 2011. For some odd reason I never went to the doctor in 2009 and therefore do not have my weight recorded for that year- and because of this I may not be approved. I would have to wait a whole year to try again if it is denied for that reason. I had wanted to wait until June/July to have the surgery but due to my endoscopy showing ulcers and hernia the surgeon wanted it rushed and told me I shouldn't wait that long- but now I may have to wait a year. What? AAUUGGHH! I'm going crazy!!!

Do they really think I had a high weight/BMI in 2008 but lost a ton of weight in 2009 and not have a high BMI and then have a high weight/BMI again in 2010. Come on- really?

Anybody have a similar situation or any advice???

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sunnyd    32

sunnyd
Posted

SO I ENDED UP GETTING APPROVED! YAHOO!!! I am calling first thing Monday morning to make an appt./get a date set!!! Super excited!!!

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Cheryl    1

Cheryl
Posted

Sunny,

I am in a similar boat as you were in. My papers should have been faxed to the insurance co last week and I don't have weight from doc in 2009. What ins co do you have? Glad to hear you were approved.

Cheryl

SO I ENDED UP GETTING APPROVED! YAHOO!!! I am calling first thing Monday morning to make an appt./get a date set!!! Super excited!!!

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sunnyd    32

sunnyd
Posted

I have BCBS- Iowa. The insurance lady at surgeon's office said I wouldn't be approved due to not having 2009 weight documented but I told her to send it in anyway- couldn't hurt. I got my approval back in just a little over a week (they said 4-6 weeks). I did find out the insurance lady at surgeon's office was relatively new so hopefully she learns a little more before telling someone they won't be approved- I was devastated!

I hope you get good news back soon! I think it's horrible people can be denied for not having a weight documented for one year if everything else is in check.

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Sweetiepea    0

Sweetiepea
Posted

Hey sunnyd:

After reading your original post is making me nervous because I have the same situation. I moved to another state in 2009 and didn't have any appointments for 9 months till early the following year. I had to call my family doctor in Texas (currently live in Iowa) to submit thier notes indicating my weight and medical information to my current doctor. We're hoping that the insurance company would take that into consideration. Insurance company had a revision in their policy of bariactric surgery and believe that I fit all criteria. I'm putting my faith into the staff at the bariactric doctor office.

So, I'm anxiously waiting to hear back from either one of them.

Wish me luck!

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