worried about getting approved

[fat in nj 0]

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.

[Lana24 10]

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

[fat in nj 0]

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.

[Lana24 10]

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?

[fat in nj 0]

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?

[FinallyFree 1]

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!

[Lana24 10]

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:

[fat in nj 0]

thank you!

[msjessy 0]

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?

[fat in nj 0]

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??

[GottaBThin 0]

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

[fat in nj 0]

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?