No requirements????

[sweetsagi 28]

I’m revising from sleeve to SIPS and was told by my doctor that I need 6 months medically supervised diet psych evaluation and all the other fun stuff. I called my insurance today and they told me there’s no requirement except I have to go through a different dept. which basically guides you through and make sure you are ready for surgery. I’ve had WLS twice. From band to sleeve and I’ve never heard this before. I have UHC. Has anyone else ever been told that??

[Healthy_life2 8,319]

2 hours ago, sweetsagi said:

I’m revising from sleeve to SIPS and was told by my doctor that I need 6 months medically supervised diet psych evaluation and all the other fun stuff. I called my insurance today and they told me there’s no requirement except I have to go through a different dept. which basically guides you through and make sure you are ready for surgery. I’ve had WLS twice. From band to sleeve and I’ve never heard this before. I have UHC. Has anyone else ever been told that??

You can call your surgeons office and discuss why he/she has given you this requirement.

[NYJenn 1,461]

Maybe because this is not your first WLS, they want to make sure you are prepared? I’d call and ask though. Seems strange for insurance to have no requirements, but the office to have 6 months

[sweetsagi 28]

Thank you.
@NYJenn that’s what I thought.

[sweetsagi 28]

So I just called my insurance AGAIN for like the hundredth time cause I need to make sure. I was told that no prior authorization is needed and the only requirement other than the BMI is BRS Called BRS and they said the service is actually optional. I’m so confused.

[SeattleLady 277]

So I just called my insurance AGAIN for like the hundredth time cause I need to make sure. I was told that no prior authorization is needed and the only requirement other than the BMI is BRS Called BRS and they said the service is actually optional. I’m so confused.

Maybe change doctors?

Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app

[49Nash 103]

My surgery is covered by the VA. I did their full program and after everything was cleared and they agreed to pay for the surgery I was referred to the surgeon. I had another 3+ months of appointments with his office, same type I had done with the VA. I think the surgeon is ultimately the one to decide if you are ready and they need to make sure you are prepared both mentally and physically

[sweetsagi 28]

@SeatleLady they called my insurance again and was told exactly they told me so since I met the BMI requirements she went ahead and scheduled me for June 24th.

[SeattleLady 277]

@SeatleLady they called my insurance again and was told exactly they told me so since I met the BMI requirements she went ahead and scheduled me for June 24th.

Good job! So now its time to get mental ready for this procedure. I glad you have your date. Now, get your self ready for this tool. Congrats!

Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app

[GradyCat 3,692]

Maybe it's because you've already been through this twice and they want to make sure you're best equipped for this procedure to be effective.

[sweetsagi 28]

I got approved!!!
This was the so easy it’s almost unbelievable.

[Repeatingthoughts 77]

That’s awesome! Congrats. May I ask, what insurance do you have ? I’m going for revision. I have emblem. They changed their recruitments last August to no longer needing a 6/7 month medically monitored weight loss “program”. My docs office were dumbfounded. I sent them the new policy which is easily found online via the provider policies. I had to forward them the info. Confirmed this via insurance advocate 3x. So annoying. I have all my appointments scheduled for the next few weeks. Hoping all goes well.