If you know the answer please reply
I have anthem blue cross, I am getting my surgery done throught SouthBay surgeons. I have to loose 37 pounds before june 2nd. I have already lost 23 pounds but here is my question. Has anyone every had to lose a certain amount of weight and was denied because they didn't lose it all or close enough?
Once surgery is approved, it is in the surgeon's hands if he wants to do it or not. He's the one to ask, as Anthem Blue Cross is out of the loop (my guess). I had RNY with Anthem, and didn't have to lose a single pound. In fact, I gained a little. Surgeon didn't care - Anthem wouldn't have known either way I figure, once they approved it.
I had to lose 10% (30 lbs for me) before they would schedule a date. On surgery date, I had gained back 5 lbs., the nurse called the doctor before they would let me into the pre-op room and he OKed it. BUT, the nurse told me that I just barely made it because the limit was 6 lb regain. I had no idea that there might be a problem. I have Kaiser ins., but I ALMOST was turned back. To get to the initial weight loss, I was liquid only for the last 3 days and did a colon cleanse the last 3 days. Just barely made it. Good luck.