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Getting Approved By Insurance



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Anyone have any tips on ensuring insurance approval? I meet all the criteria but have oftened wondered if during the monthly check ups with your doctor you are brutally honest and say "no, I haven't worked out like I should?" if that will affect approval. Does the insurance company say..."this person hasn't done what they have been asked to do."

Or should I just go and tell my doctor exactly what they want to hear..."oh yeah, doing exactly what is asked of me....all day,....everyday."

Which we all know is not true but I have tried to lose weight for YEARS and now I am just going through the motions to get approved.

Thoughts, suggestions?

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This going to be interesting I was thinking the same thing ... My doc ask me have I done weight watchers . South beach ect .. I said no but I have been on diets where medication was prescribed but i wonder if not had done all those other ones will it matter

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Your surgeon's office is the entity that submits your paperwork to insurance. It is in their best interest to present your case in the most favorable way in order to insure approval. They don't get paid for doing the surgery if the surgery is not done. That being said, I honestly believe they do everything possible to make sure you get approved on the first submission. Failing to do so just creates more work for them and the doctor if peer to peer review is involved.

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I think the only thing you can really do to assist in getting approved is to try to do what they recommend. I had no faith that I would be approved but my nut assured me that I would be. She said I didn't gain weight and I did all of the required tests. In her office, she said she had never seen anyone denied who had done those things. Hey, I was approved!

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I asked my nutritionist this exact thing the last time we met. She told me that insurance company just wants to be able to check the box that you met the requirement. They don't care about the results. She told me that some people really need it because they had no idea what a proper diet should look like. For others, like me, she doesn't have much to tell me past the 1st session. She'd be happy with me losing 1 pound a month for a total of 6 pounds but the insurance company doesn't care.

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All depends on the insurance company because I've read on a forum where someone was denied for being noncompliant with the 6 month diet.

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