Approval question

Lablvr64
on 9/21/07 8:11 am - Oak Creek, WI
As anybody heard of denials based on not enough Co-morbidities? I don't have High Blood pressure or Diabetes. I don't have heart disease or sleep apnea. Basically I'm " Just " obese with a BMI of 42.  I'm afraid I won't get approved for surgery. I meet with Dr. Chua next week but have been through the 3 months of dietician visits that my insurance requires and the psych eval. God I would be so disappointed if I were denied. Anybody have any words of wisdom or knowledge of approval or denials?? Thanks...   Shari
saraczek
on 9/21/07 8:06 pm
From what I know of the approval process... You need to have at least  a BMI of 35 or over.  I think for the experiences people have shared at our support group meetings, the closer you are to the 35 the better for approval with co-morbidities.  With you having a BMI of 42, I would think you will be just fine for approval.    At the time of my surgery my BMI was right around 36 and I didn't have any comorbidities other than borderline high blood pressure.  My approval went through just fine.  Doesn't pay to worry about it, I'm sure it will be just fine.  Good luck to you.
lillysummer
on 11/28/07 11:05 pm - Superior, WI
I too am worried that I might not be approved for RNY.  I have a BMI of 36, am 5'6" tall and weigh 223 (as of yesterday).  I do have heart disease (Angina).  Soon there will be a surgical POW WOW regarding my case, so I remain hopeful.  I do not have sleep apnea or diabetes.  My PCP feels that I'm a good candidate for surgery, that's a plus.  GOOD LUCK! Lillysummer
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