Question, please!

So my insurance denied me. The surgeons office said it is because I needed to see my psych about binge-eating (which I was never told I had?)  BUT!!!! I just got my denial letter, and it says I was denied because my BMI is under 40 and I have no severe medical conditions.

NOW! My starting BMI was a high 41 (41.8), when I lost the weight my insurance said I had to lose, my BMI is not 38....arent they supossed to submit the STARTING BMI?  If this is the case, its an easy fix and just needs to be submited with my actual starting BMI....right?

I hope this is the case and it was jsut an opps moment mix up.

Did anyones surgeon submit their ending BMI???? Or was it your start???

I was told they use the initial BMI from your first visit. I think it would be an easy fix, your surgeon's office should resubmit with the starting BMI.

If you qualify at your very first inital visit then you should be fine. I would ask them to resubmit. That makes no sense to me.

Hi Mary- it''s the insurance, not the surgeon. My insurance used the ending BMI after weight loss program. Surgeon's office at times works with patient to ensure they do not fall below BMI before paperwork is submitted. Sorry   May or may not be an "easy fix", depends on your insurance company. Jenny T

I just asked this question at my surgeon's office on Thursday as my starting BMI was 41.  I am now at 40.2.  I was told they submit the weight and BMI taken at the very last visit before submitting it to insurance - NOT the first visit.  I was required to have four nutrition visits and lose 5% of my weight by my insurance company.  I'm there, but I have to stay at this weight until my 4th nutrition visit at the end of April.  If I lose 2 lbs, I will no longer qualify.