So I had my last nutritional visit on Sept. 15, and of course had gained back the few pounds I lost, which put me 2 pounds over my starting weight 6 months ago. The nutritionalist says the surgeon will not schedule my surgery until I have lost some weight. I have tried seriously I have, I can lose it comes back. I have counted calories and carbs cut the weekly glass of wine, and even bacon( the only pork I eat) out of my diet. Was diagnosed with sleep apnea and have used my CPAP every night since I have received it. I walk 3-4 miles 4-5 days a week. Anyway, the nutritionalist said they would submit my paperwork to the insurance company anyway on the 15th despite not having lost the weight but to keep trying . Well I call the insurance company today and low and behold, they have not received any paperwork at all. I am so pissed. I was shooting for the end of Oct. surgery since I have met my insurance deductible and may have to travel for my job in December. Just speechless right now.

Might be time to find a new Bariatric center?

Switch Drs. I went from first visit to surgery in 8 weeks.

I didn't have to play all these reindeer games with my program. A lot of these programs are just milking people for money.

Edited October 4, 20178 yr by OutsideMatchInside

3 minutes ago, OutsideMatchInside said:

Switch Drs. I went from first visit to surgery in 8 weeks.

I didn't have to play all these reindeer games with my program. A lot of these programs are just milking people for money.

It also depends on the individual insurance requirements. In my program, some people went to surgery within 8 weeks and some like me had to play reindeer games due to my insurance company's requirements.

3 minutes ago, Killian said:

It also depends on the individual insurance requirements. In my program, some people went to surgery within 8 weeks and some like me had to play reindeer games due to my insurance company's requirements.

True, but it doesn't seem like insurance is the issue, but her program. Her BMI is over 40, most insurance doesn't require you to jump through a lot of hoops with that kind of BMI.

15 minutes ago, OutsideMatchInside said:

True, but it doesn't seem like insurance is the issue, but her program. Her BMI is over 40, most insurance doesn't require you to jump through a lot of hoops with that kind of BMI.

That would be great. However, my BMI is over 40 and I had to play the reindeer games because of my insurance

I had to play the insurance games, I have completed all the testing, paid all of the copays, met my out of pocket expenses/deductibles, 6 months of supervised dieting. I just called the center to speak to someone and of course the program director and nurse are out of the office. I live in a small town, so my options are limited on switching programs without almost starting over, not to mention the time away from work to make go to appointments. I am waiting on a call back. Just needed to vent, thanks for listening.

Hang in there...did insurance require weight loss/no gain or just 6 months diet supervision? Did ins state they would deny you if you gained?

Keep at them.

5 minutes ago, Sosewsue61 said:

Hang in there...did insurance require weight loss/no gain or just 6 months diet supervision? Did ins state they would deny you if you gained?

Keep at them.

Insurance required the 6 months diet and nothing is mentioning about gaining any weight, it's the surgeon I believe that wants the weight loss. I just had a planned timeline of how this would flow with my work schedule and this throws a monkey wrench in them. I'm going to stay on them. I mean I still have to do the pre-op liquid diet before the surgery but I can't start that until I get a surgery date, can't get a date until paperwork is submitted.

The same thing happened to me. My insurance didn't get my paperwork and it took two weeks for my office to respond and send it over. I called the insurance company every day and they called the doctors office for me and asked them to fax it. It took one day for my insurance to approve it had my office been on the ball. Luckily I finally have a surgery date. Stay diligent!!

I just got an email from the center's director so basically, since I had not met the weight target set by the surgeon, she had not submitted my paperwork and so depending on my weight loss, she will submit it. Not acceptable, lets just say she got more than an ear full from me. I understand they want you to lose weight but we are talking 5lbs. (seems like they don't want to leave me) and that's before I even start the Pre Op diet. Praying the paperwork is submitted by the end of the week so I don't hurt this director

On 10/4/2017 at 2:09 PM, Killian said:

That would be great. However, my BMI is over 40 and I had to play the reindeer games because of my insurance

Insurance might require a 6 month program but I have never read in any insurance policy that you are required to lose weight. Dr Offices set that requirement.

if someone has a super high BMI over 60 and it is unsafe to do surgery until they lose weight, okay. However there is no reason to drag it out and require a lower BMI person to lose weight. If people could lose weight on their own they wouldn't need surgery.

Obese patients are still discriminated against to get services, in ways that would not apply to other medical treatments.

I just got an email from the center's director so basically, since I had not met the weight target set by the surgeon, she had not submitted my paperwork and so depending on my weight loss, she will submit it. Not acceptable, lets just say she got more than an ear full from me. I understand they want you to lose weight but we are talking 5lbs. (seems like they don't want to leave me) and that's before I even start the Pre Op diet. Praying the paperwork is submitted by the end of the week so I don't hurt this director

This to me is complete BS. My weight can fluctuate by 5 pounds just based on where I am on my menstrual cycle. I also bloat/hold water in the summer. I barely lost anything on my pre-op diet because it was 105 degrees every day of my diet and I was bloated the whole time.

Edited October 7, 20178 yr by OutsideMatchInside

I'm so sorry to hear you're going through this!

I have my second visit with the surgeon on Monday and I'm terrified this will be my outcome. All my weight has done this month is bounce up and down and I'm supposed to be 5lbs down when I see him...

I have Aetna, amd they require three months supervised diet, with no weight gain. I use this stuff called Teami tea, a colon cleanse that helps with a pound or two. I went through Irma this past month and had gained weight. So four days prior to weight in I went on a full liquid diet and drank the Teami tea (double dose) and lost 1.2 lbs from my previous months weigh in. I suggest you do this and get weighed again. Now I'm one month away and trying so hard not to binge this last weigh in is so important. Good luck to you. Keep us abreast of what's happening!

Sent from my SM-G935P using BariatricPal mobile app

On 10/4/2017 at 5:35 PM, FabNFit@40 said:

I just got an email from the center's director so basically, since I had not met the weight target set by the surgeon, she had not submitted my paperwork and so depending on my weight loss, she will submit it. Not acceptable, lets just say she got more than an ear full from me. I understand they want you to lose weight but we are talking 5lbs. (seems like they don't want to leave me) and that's before I even start the Pre Op diet. Praying the paperwork is submitted by the end of the week so I don't hurt this director

what was the out come did your get it squared away?

Stay on top of the Dr. It maybe in the front office waiting to be faxed or waiting for the Dr's signature, hard to say, but stay on them. I have had to fight my insurance on 1 issue (a test) and push my Dr to rest my date as well.