MY BMI IS TOO LOW TO GET DS WITH DR K

I also found this in the 64 pages of my policy.  So we will see

harges made for medical and surgical services for the

treatment or control of clinically severe (morbid) obesity as

defined below and if the services are demonstrated, through

existing peer reviewed, evidence based, scientific literature

and scientifically based guidelines, to be safe and effective

for the treatment or control of the condition. Clinically

severe (morbid) obesity is defined by the National Heart,

Lung and Blood Institute (NHLBI) as a BodyMass Index

(BMI) of 40 or greater without comorbidities, or a BMI of

35-39 with comorbidities. The following items are

specifically excluded:

 medical and surgical services to alter appearances or

physical changes that are the result of any medical or

surgical services performed for the treatment or control of

obesity or clinically severe (morbid) obesity; and

 weight loss programs or treatments, whether or not they

are prescribed or recommended by a Physician or under

medical supervision.

People at the docs office think they are the know-all-end-all ofr insurance.  Definitely call the insurance co yourseslf.  If I'd have listened to the office clerk myself, I'd have done 6 mos of diet needlessly.

Do you have comorbidities?

Yes I am type 2 diabetic, anemic, arthritis, acid reflux, degenerative disc disease, asthmatic and have fibromyalga

Do they (Dr. K's office) know you have co-morbidities? Do you have documentation of these from your current Doc's? It sounds like you meet the criteria to a revision to current RNY.  I do not think you could wear enough clothing, hide rolls of quarters or even wear weights to gain 20 lbs. 

Good luck,

Whitney

They didn't have my records when she called. If they approved me for wls they agreed I need it. So im thinking that since it doesn't say i have a bmi of anything but 35 with comorbids or 40 without, plus dr K is so highly thought of Im sure he will know how to get it approved if He thinks i need it. If not you are gonna see this chick eating her Azz on instead of off. Lol 2 months to gain 20 pounds. I can do that in a week granted its usually water weight and will go away with a water pill. Lol but i think i wont have to.