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Denied The First Time?



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Has anyone besides me been denied the first time then was approved the second time by the surgeon? My insurance covers it.

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I have not submitted to the insurance yet. But, many others have posted on here about their denial experience. You can have your Surgeon or pcp write a letter of medical necessity. You could ask your Surgeon's office to arrange a peer-to-peer review.

Make sure it's documented that you meet the requirement.

Keep trying. Don't give up.

Good luck!

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My thing is the first time I had my meeting with the surgeon he said basically I didn't qualify I had the bmi of 39 and it needed to 40 or greater. Well now I'm going back to see him I'm at my normal weight which is 242-245 I was 215 at the time an I'm 5'2. I was going through a divorce and I did not eat so I was basically starving my self when I loss 34 pounds.

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You have to stay on top of this. Don't give up. After you see your Surgeon then find out from maybe the office coordinator or who is in charge of your case what else is needy. and be pro active for your self. We are here for support.

Keep us posted.

Good luck.

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You are not alone.

My weight is 264 and I have concerns too. i have no approved co morbidities. But I will work hard follow the program ect. So I can Rock my sleeve soon!

Keep you head up girl.

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Here at the hospital in ga the surgeon says bmi 35 with comorbidities and 40 and above automatically approved. So I'm hoping this time I can get approved with the bmi of 43 almost 44

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I've been denied & currently in appeal. :/ coordinator submitted with missing info... Ugh

++++++++++++++++++++++++++++++++ 347*294/284/135 (*347HW/294SSW) | (twitter) @Mwrarr | mwrarr.wordpress.com

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I was denied the first time by the actual surgeon my bmi was 39 and I didn't have any problems. My bmi now is 44 and I have been having pcos.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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