Second denial. Ugh! OK, guys, what's next? Gear up for battle? Give up?

VSG on 06/12/13

I just called UHC and apparently they're taking the "we require 40 BMI; we don't care about 35 with comorbids" seriously. I have a second denial letter heading my way today. Ugh! I am presently at a 38.9 BMI, with comorbids.

Seriously? You're telling me I am not fat enough for this? I wish I could say I have confidence in my surgeons' insurance coordinator's ability to fight for me on this, but I don't at the moment.

What's next?

I have looked on the insurance board and it seems more like folks asking questions than giving advice. 

Do I give up? Do I keep fighting? If I keep fighting, what is my angle of attack? Is it time to call Lindstrom's group? Switch surgeons to someone who will tackle this head on? I cannot help but feel that because there are many folks walking in the door of the surgeon's office, I'm receiving minimal support/effort on this, and if they don't make the money with me, they'll make it on the next person. My usual approach is to just take over but this is a topic I know nothing about.

Feeling very lost and defeated at the moment. If I looked as deflated as I feel, I wouldn't need surgery.

Any and all war stories/specific steps of advice are most gratefully welcomed at this point. 

 

   

Sleeved 6/12/13 - 100 pounds lost to get to goal!

Jilly Bean
on 1/17/13 2:27 am - IN
RNY on 07/09/12

Gain a couple of pounds?  I did.

Surgery weight:  232 lbs. / Goal: 145 lbs. Height:  5'5"     Fat? Ain't nobody got time for that.

 

ToNewBeginnings
on 1/17/13 2:30 am

That was my thought.

I know it may sound terrible....How much would you have to gain? ....15 or 20 pounds?

Jilly Bean
on 1/17/13 3:09 am - IN
RNY on 07/09/12

I think I gained 7 pounds and that was enough to push me over 40 BMI.  I lost it right away and went to surgery with a BMI of 38.6.

 

 

Surgery weight:  232 lbs. / Goal: 145 lbs. Height:  5'5"     Fat? Ain't nobody got time for that.

 

bobbirenee
on 1/17/13 2:33 am
RNY on 01/08/13

Your BMI is so close to 40... I agree just gain a few more pounds. It will be worth it in the long run because you will get your surgery.

 

Best of luck to you

AprilM1969
on 1/17/13 2:33 am - OH

That was my thought gain some weight?  Also if you don't feel confident in your surgeon's office I would seek a new surgeon...you should feel confident in the office staff as well as the surgeon.

stanggirl89
on 1/17/13 2:37 am - DE

is it wrong to say gain some weight..lol i wouldnt give up. fight!! even after the surgery your in a battle to do whats right..eating healthy..and staying strong!

  
May 16, 2012

HW:345 SW:329 GW:200(Jan 30,2013) 

Amanda M.
on 1/17/13 2:39 am
RNY on 01/18/13
Unfortunately, a lot of insurance companies dont care what your surgeon says. Policy is policy. I hate to say it, but gaining a few pounds may be your best bet right now. Or carry a couple rocks in your pocket for next weigh in
          
Paula C.
on 1/17/13 3:14 am
On January 17, 2013 at 10:39 AM Pacific Time, Amanda M. wrote:
Unfortunately, a lot of insurance companies dont care what your surgeon says. Policy is policy. I hate to say it, but gaining a few pounds may be your best bet right now. Or carry a couple rocks in your pocket for next weigh in

That is what I did! Put lots of change in my pockets, didn't empty my pockets!

Amanda M.
on 1/17/13 3:23 am
RNY on 01/18/13
My surgeons nurse even said that a lot of people close to 40 will cheat, because in another 6 months they will probably be that anyway. I am lucky my insurance didnt require a 40 BMI and considered my co morbids. Otherwise, I was prepared to do what I had to. Lol
          
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