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

May Not Be Approved! WHAT?



Recommended Posts

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???

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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???

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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!!!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

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

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 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

    ×