Denial

I am currently in the process of getting all the requirements done to get an approval for the gastric bypass. My doctors office is telling me I need to lose weight to be back down to what my weight was when I first had my consult almost a year ago. She told me that if the nutrionist did not think I have been compliant then she can basically tell the surgeon I'm not ready for surgery and then they will deny me. Has anyone else had this issue?

I suppose that your chosen surgen can deny you ---- that would not be the same thing as your insurer denying your claim.

I don't know the specifics of your insurance plan ---- if part of the plan states that you have maintain a specific weight range for a specified amount of time -- and you have not complied, then I guess they can deny you.

If this particular surgeon wants their patients to lose weight -- and maintain the loss without surgical help -- and the process takes a year -- that is a lot to ask -- but I suppose they can legally deny you their services if they want to.

Thank you for your response. I'm going to call my insurance tomorrow and try to understand. I feel the doctors have been giving me a run around. 

Normally, a nutritionist doesn't have the power to recommend that you not have surgery. Most surgeons are also smart enough to know if you could have stuck to a diet long term, you wouldn't need surgery....

That's what I thought.....I mean I wish I could lose the weight by myself but I obviously cant. I'm scared enough as it is to have the procedure and their tactics and keeping me on a sesaw definitely has my anxiety working over time.

I would find a surgeon who didn't allow his nutritionits to make surgical decisions for his patients. 

If that is a requirement he himself has made that is different,but I personally,would find a surgeon who didn't have these requirements.

I really feel for all of you.  Back in the day when I had surgery we didn't have to lose weight before surgery.  If you want surgery you have to do what is required but if we could lose weight on our own we would not be considering having surgery.  

The other members are right, a Nut should not have the say if you have surgery or not. If you have to find another surgeon. Good Luck and keep us posted on how you are doing