Insurance Denial

k9ophile
on 12/19/11 10:42 am, edited 12/19/11 11:16 am
One thing I would not do is follow any advice to scrunch down or add weights such as rolls of quarters or ankle weights etc. to reflect an artificial BMI.  That is fraud.  If discovered by your insurance company I think the least they could do is refuse to pay with the worst case scenario being that they charge you with insurance fraud.  Do you really want to risk that?

"Our ultimate freedom is the right and power to decide how anybody or anything outside ourselves will affect us."  Stephen Covey

Don't litter!  Spay or neuter your pet

fullhousemom
on 12/21/11 4:03 am
My height has varied from 5-7 1/2 to 5-6 1/2 since I was a junior in high school.  I am 47 years old now.  No fraud is being taken place.  My pockets are empty and my shoes are off.  It all depends on the day and how I'm feeling I guess.  My surgeon took the 5-6 1/2 and rounded down to 5-6 and I fit in the charts.   The typical chart doesn't have the 1/2 inches.

My guess is that as I have gained weight, I want to be taller to put off the lecture from my PCP about my BMI and losing weight.  When my weight is down, I relax a little standing against the wall.

I would never knowingly commit fraud or even suggest it to anyone else!
ynona74
on 12/19/11 10:53 pm - Lakewood, CA

Good morning everyone...thank you for all your help. while some of you suggested I commit insurance fraud by "shrinking" or carrying some extra change...I don't think that you meant any harm. I am going to call my doctor and have him check me for sleep apnea. That is one of their comorbidities. I have already been tested for all other comorbidities and I do not have them thank the gods, but at least sleep apnea if I do have it will get me into the program sooner.

alldredget
on 12/19/11 11:10 pm - Comstock Park, MI
I first looked into weight loss surgery 6 years ago and one of the reasons I didn't get it done was because I didn't want to go through a doctor supervised 6 month weight loss process. It has been 6 years, I am heavier than I was then and I finally decided to do it a year ago. I got my insurance approval earlier this month and meet with the surgeon tomorrow.

Basically, you need to contact your insurance provider and find some doctor supervised weight loss programs in your area that they will cover and qualify you for the surgery, then do it. If your BMI is 39.9, you will be over 40 in a few years nearly guaranteed.

Unless you have 30 or 40 grand laying around, you are going to need to go through the process, it is a pain in the butt, however you will get there. 
ynona74
on 12/19/11 11:19 pm - Lakewood, CA
thank you. I will jump through all the hoops I must, because I am tired of being obese. Good luck with your procedure and let me know how it goes.
MsBatt
on 12/20/11 2:07 am
Unless you have 30 or 40 grand laying around, you are going to need to go through the process

Not quite true. It's quite cost-effective to go outside the US---last I heard, you could get a DS done with a world-class surgeon in Brazil for about $16K, everything included.
fullhousemom
on 12/21/11 4:06 am
I paid cash for my DS and it cost $7,000 for my surgeon and $11,850 for the hospital.  It was done in the Detroit, MI area.
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