Possible denial for lack of pre-op weight loss?

I'm very close to the end of my insurance requirements. I have United Healthcare backed by Medicaid in Ohio.

I have been gaining and losing the same 10 lbs for a few years. I'm seeing the nutritionist and she said that I may get denied because I haven't really lost anything.

Any thoughts on this?

You appeal. And appeal. And appeal.

After all, why do you want to do this? Because you can't lose weight. Point proved!

Thank you. She was just kinda crappy about it. I've been on the revision journey, officially, since May of last year. I'm so ready to move on to post op.

Just don't give up. That's what they WANT you to do!

For me they just wanted to see the effort documented by my physician. The actual weight loss seemed to not be the point. I wouldn't worry. Hopefully it will be like mine was.

Hey Pete!

I am hoping they will see the struggle. Btw, I will be having the DS with Dr. Schauer. I've seen him once so far and he signed off on me already. I really like him. He answered all of my questions thoroughly. He pointed me to resources about wls and psoriasis-a huge problem of mine.

I questioned him and the staff on the fact that he isn't listed as a vetted DS surgeon, and I was impressed with their answers-and, frankly, their lack of attitude when I mentioned my concern.

Good for you. I think Schauer is a great surgeon. When I first saw him he laid out all my options and the pluses and minuses for each as he felt they applied to me. It was the most informative session I had ever had with a Doc about my weight and weight loss. I'm a big fan. Feel free to mention my name they did send at least one person my way to discuss what I thought of my DS so he might remember me. I have my 4 year checkup on 5/5 but I now see an associate Doc and not Schauer himself.

The nutritionists all mean well but they can be a mixed bag. After looking at the vitamin regime they had 4 years ago and what people talked about online I decided to go my own way. Being closest to the ASMBS guidelines for the DS. The nutritionists I saw didn't have a problem with that. The one thing I wish I had done differently early on for vitamins was to bite the bullet and start the 50k biotech vit D right away. Instead I went up 6k here 10k there and ended up at 50k anyway (at two years I went to 100k, 2 50 twice a day).

The last time I went through vitamins with the nutritionist she thought the multi ADEK's were the better way to go and they won't hurt early on but it's cheaper and more effective later to do them all separate. Aside from all the discussions (arguments :) ) you'll see online about them being a bad idea.

The whole key is to follow your labs and the clinic does a great job at doing labs the first year and while I have a spreadsheet with lab values I find MyChart the easiest way in the world to check your tests from the clinic.

Pete Apostle

It depends on your insurance policy, and sometimes on the surgeon. It's not the nutritionists decision. Keep trying, but don't let this person's negativity stop you.

Larra

"The requirement is to take the program, not to hit a target."

Thank you! That was my thoughts as well.

My initial consult with a nutritionist, which kicked off my program back in May, said that any weight loss would be a good thing for me and the surgeon, but it wouldn't exclude me if I didn't meet that goal. I am 308 with a goal of 288. I have gotten down to 299...then up again. :(

This nutritionist from the other day was a different one. She's brisk and I just am having a hard time with her. And we don't get to choose which one we see, either.

Uhg. I will appeal as much as necessary if it comes to that.

I guess my biggest problem at this point is the balancing act I am trying to do. I have Medicaid, so I can't go back to work in my field. I would lose insurance-though pick up the company one-and then have to accrue sick/vacation time.

But, to work part time and maintain my benefits means retail/food service. I am NOT too good for these types of jobs. Lets be clear. But, I can't physically do it.

My patience is running low and that makes me hungry, lol.

Sorry for the mini-rant. I'm just frustrated and I needed to vent to people who get it.

Thanks for listening.