my pre-approval 6 mth weight loss might disqualify me from DS

lamp35
on 11/7/11 4:25 am
3 weeks ago, my BMI was 50.8, which put me just above the threshold for qualifying for DS thru my insurance company.

When I spoke with the insurance contact at Duke Metabolic Center today, she said they will submit to the insurance, the weight that they record on the day I meet with the surgeon.

Since I am on a weight loss program, I will likely come in far under the 50 BMI.....I dont want to NOT lose the weight to keep my BMI high, because I dont want the insurance company to see a pattern of non-compliance with weight loss.

anyone else had a problem with the BMI drop disqualfying them for DS?


GloryG
on 11/7/11 6:52 am
No, but I gained weight during my 6 month pre-approval and was approved with no problem. I didn't gain that much, and was not trying to gain since my BMI was already in qualifying range, but I have not heard of people being refused because they gained weight. If I could have lost weight because someone told me I had to, of course, I never would have needed the surgery.
(deactivated member)
on 11/7/11 7:21 am - San Jose, CA
Tell them they are supposed to submit your weight on the first intake appointment date, not after you have proved compliance with a strict pre-op weight loss requirement.

And you might want to consider requesting waiver of the 6 month program: http://s3.amazonaws.com/publicASMBS/GuidelinesStatements/Pos itionStatement/ASMBS%20Position%20Statement%20on%20Preoperat ive%20Supervised%20Weight%20Loss%20Requirements.pdf
Not yo business OH
on 11/8/11 5:55 am
Like Glory, I gained weight during my 6 month. I would check back with Duke about the weight documentation. They used my first weight. Best wishes.


    

Ht: 5'7"  HW/247ish   SW/234    CW/141-145  (Over 100 pounds lost in 8 months!)    
Most Active
Recent Topics
calcium/protein
PTcoki · 6 replies · 362 views
Need help for my mom
Fire_Ice · 1 replies · 135 views
How can I gain weight?
DEJanieT · 7 replies · 1051 views
×