Question:
Do the Insurance Companies Verify your weight loss records?

Does anyone know whether the insurance companies verify the records of your prior weight loss attempts by calling the physician or weight loss center or do they take the records at face value? The reason I ask is that one of the doctors I had seen for weight loss (not my PCP) is not in favor of my decision to pursue surgery and thinks I can still lose 200 pounds without a gastric bypass. I don't want the insurance company to call him to verify my weight loss records and for him to try to convince them that I am not a good candidate. Many thanks.    — blank first name B. (posted on October 1, 2003)

October 1, 2003
I think the only time they ask for copies of records is if you are proving a physician-supervised diet, and maybe to prove you have been a certain weight (or more) for a certain period of time. I think the fact that this other doctor expected you to loose 200 pounds without surgery is something the insurance company won't take into account - now if he said stuff about you not being fit for ANY surgery, that would be differnt, but his overall opinion about GI bypass will be irrelevant if your insurance has exact criteria and you are meeting it.
   — bethybb

October 1, 2003
My ins. co didn't ask for any of mine even though they said it was needed
   — Cathy G.

October 2, 2003
Go to your new doctor's office and fill out a form to have the old doctor send a copy of your records to the new place. They'll usually fax the request. Then, when you get ready to submit thru your surgeon, you'll have everything coming from one place. I've worked with an insurance company and I know they don't call all of the doctors and ask their views on your decision to have WLS. I just walked in to all of my doctors offices and had them make my copies and carried them myself to the surgeon. Had NO troubles. Good luck to you! Kimberly
   — Kimberly S.

October 2, 2003
Blue Cross Blue Shield of IL. just requested more information from my PCP regarding my previous diet attempts and the amount of weight lost/gained. They said the review board would make its final decision after they reviewed my PCP's records. I also sent in my WeightWatchers card that showed my weight loss. I think they are about to hit me with a required 6 month doctor supervised diet before they will approve surgery.
   — Kara J.