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

worried about getting approved



Recommended Posts

hello-

Has anyone gone to the Barix Clinic in NJ? Was it hard to get approved by the Dr's and your insurance? I have Amerihealth they do cover the surg. but my BMI is just at 40 w/ no other problems.

Share this post


Link to post
Share on other sites

Hi fat in NJ,

It all really just depends on your policy, see if you have the written policy or if you can access it online. That is your starting point, see what they require then try to fall within those guidelines. And remember if you get denied, reapply. I had to 3 times before getting an approval. Good luck

Lana

Share this post


Link to post
Share on other sites

thank you for your help. I did contact my insurance company and found the policy guidlines online. my problem is I hate to go to the Dr when I'm fat. I have some medical records from 2001- 2008 but my weight went up and down the hole time is was'nt a BMI of 40 the hole time.

Share this post


Link to post
Share on other sites

thank you for your help. I did contact my insurance company and found the policy guidlines online. my problem is I hate to go to the Dr when I'm fat. I have some medical records from 2001- 2008 but my weight went up and down the hole time is was'nt a BMI of 40 the hole time.

Does your insurance require you to have a history of a BMI of 40 or above?

Share this post


Link to post
Share on other sites

Does your insurance require you to have a history of a BMI of 40 or above?

The insurance policy states " the individual has either ONE of the following- A body mass index BMI greater than or equal to 40 OR BMI between 35-40 in conjunction w/ one or more comorbidities.

it also states has documentation of failed history of medical weight loss.

That's the part I'm worried about I never saved receipts from diet's or gyms. the medical records i have show my weight went up and down from 120 lbs to 220 lbs the highest being just recently.

Did you have alot of records? or do they ask for alot of records?

Share this post


Link to post
Share on other sites

The records don't need to show that you have attempted wgt. loss during the 5 yr. period.

I had 5 yr. worth of medical records (ob/gyn, orthopedic, GP, etc) that showed my weight varied and proved I was over weight.

If you do need a co morbidity, I bet you do have sleep apena (like I did and didn't know it) because of your weight.

Good luck! I hope it goes fast for you, so you can have a better life!

Share this post


Link to post
Share on other sites

The insurance policy states " the individual has either ONE of the following- A body mass index BMI greater than or equal to 40 OR BMI between 35-40 in conjunction w/ one or more comorbidities.

it also states has documentation of failed history of medical weight loss.

That's the part I'm worried about I never saved receipts from diet's or gyms. the medical records i have show my weight went up and down from 120 lbs to 220 lbs the highest being just recently.

Did you have alot of records? or do they ask for alot of records?

ok, so you are on the road... I needed proof I had tried other things as well. You doctors office should be able to tell you what they have been able to submit in the past. All they wanted from me was a list of things I had tried over the years... I had 2 pages of diet programs exercise programs etc... and that was all I had to do. So call your surgeon and ask them what they need to get you approved...

Good luck LANA:thumbup:

Share this post


Link to post
Share on other sites

Hi fat_in_NJ. I just wanted to see how things are coming along for you?

I also have Amerihealth, but live in NY (Long Island) and wanted to get someone else's take on how things are with this insurance. I went thru all of my pre-testing for the surgeon's office, which included all of the things the Insurance asks for.

My BMI is 47 and I do not have any co-morbities.

Are you approved? Did it take long for you to get approval?

Share this post


Link to post
Share on other sites

HI- Amerihealth was VERY easy for me. I was approved in about 6 days after I had my first consult. My BMI was 40 w/ no other problems. The surgen wanted me to go for a phych eval and a sleep study. Amerihealths reguirements were the same as the Dr.'s so far I have to do nothing other then what the Dr told me in the consult. BUT the Dr conviced me to have bypass surg. I Hope I'm doing the the right thing But I talked with two dr.'s and they both prefer gastric bypass??

Share this post


Link to post
Share on other sites

I just called my doctor today to say I need to do this. Once your testing is done, how long does it take to get approved?

GottBThin

Share this post


Link to post
Share on other sites

I got approval before I even started the surgens requirements. I started making the appointments, but had not gone to any yet. The insurance requirements were the same as the dr.'s so once I'm done w/ the surgens requirements they hopefully can schedule me for my PAT test and then surgery. I belive they schedule both at the same time PAT and then 2 weeks later surg. from what I'v read. What made you do the Lap Band?

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

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 1 reply
      1. BabySpoons

        Amazing! Congrats!!! Watch out for the sharks. 🦈

  • 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

    ×