Question:
Anyone use Obesity Law Institute's Early Approval Plan?
— Vikki L. (posted on May 21, 2003)
May 21, 2003
Many, many people have been approved without the help of such a place as
this. If you would be one of those, then you're gonna spend $245 for
nothing. If not, then all you are getting is a $245 credit TOWARDS their
fee charged for appealing. I just looked on their site and that is $495.
If you get denied initially under this Early Approval plan, you are still
laying out the $495 ($245 initially and $250 later) that you would have
laid out if you had been on your own in the beginning. Personally, if you
have a good case for surgery, then don't worry about retaining these people
unless you are denied...just my opinion...JR
— John Rushton
May 21, 2003
Yikes. I agree with John. This sounds like a waste of good money to me.
And a bit of a misnomer -- "Early Approval Plan?" It's the
insurance company that approves, not the submitter -- just exactly how does
this make your approval guaranteed, or more likely, or "early," I
wonder. Plus, I would think the insurance companies will quickly catch on
once they start getting a standard boilerplate submission (customized?
doubtful) from a (non-medical) source supporting coverage. In a word:
Ugh.
— Suzy C.
May 22, 2003
I would stay away from this, like the other posters. Sort of an
unscrupulous way to get money from desparate people - and how many obese
folks have been duped by "diets" and "products guaranteed to
make you lose weight" in the past? My insurance covers WLS, but my
husband was denied because he didn't meet the BMI of 40 or over criteria.
I wrote his appeal letter (I think I know him better than a stranger!) and
he was not only approved, but the criteria was changed! And, it didn't cost
$245.00.
— koogy
May 22, 2003
I agree with previous posters that there does not seem to be a clear
financial advantage to doing this prior to the first denial. However, the
gentleman in charge is both a DOCTOR and an ATTORNEY (WOW!), therefore I
should think insurance companies would pay attention when he lays out the
MEDICAL and LEGAL reasons that a patient should be approved (or should not
be denied, depending on your perspective). If I knew I were working with a
difficult Insurance Company, or knew my documention was not quite "up
to snuff", I might have considered a preemptive strike such as this.
— [Deactivated Member]
May 22, 2003
This sounds like a scam to me. Talk to your doctor's office. They should
be able to give you all the help you need. My doctor's office was an
incredible help. Although I wrote the letter to the insurance company, and
provided the necessary documentation (diet history, etc.) they did the
filing, the co-morbidity analysis, and had my approval in no time. If your
surgeon and his staff aren't willing to be supportive in your quest for
approval, I would get another surgeon. They should want this for you as
much as you want it for yourself.
— Carly B.
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