Question:
If you lose weight after initial consultation but before surgery can you be denied
During my initial consultation with my surgeon I just barely made the weight criteria for the surgery. My insurance has approved me, but i've lost some weight due to being sick recently. If I don't regain the weight, will this affect me being able to have the surgery? After the initial consultation do you get weighed again at all before surgery? — [Anonymous] (posted on January 5, 2002)
January 5, 2002
Each insurance company has different criteria, but most rely on the initial
numbers given by your surgeon. So as far as my insurance company is
concerned I weighted 331 when operated on. My surgeon required me to lose
weight so that I could have the lap procedure done and that morning in the
hospital I weight 312, but all my records showed my weight as the 331--well
within the surgery criteria. What may relieve your mind a bit is the
realization that the surgeon's staff will 'work' the insurance company to
make sure you get approved. I didn't say lie, but the staff knows the ins
and outs and speaks 'insuranceish' better than we as patients generally do.
Let the surgeon worry about the numbers reported to the insurance company.
— [Anonymous]
January 5, 2002
I was in the same boat as you when I saw my surgeon. I was very borderline
eligible for surgery. It was strongly stressed to me that I not lose
weight before the surgery as in the end the insurance may refuse to pay.
My surgeon had seen companies do that before. Thank God as my surgery got
closer I pigged out on all my old favorites because the weekend before I
was so nervous I threw up and had diarhea for three days! By the time
surgery rolled around I ONLY had five pounds to spare. I'm not saying to
try to out do you insurance, just know that people have been denied cause
at time of surgery they did not weigh what they did in the consultation.
Good Luck! Amy
— purdue_1993
January 6, 2002
I gained about 12 lbs. (which I am sorry about now post-op) between my
first consulation visit and the actual surgery date. The closer my date
got, the more I ate. Getting those last meals in, I guess. AND..stress!
— Annie H.
January 6, 2002
Why tell him you lost any weight?? They didn't weigh me the date of
surgery... I went and weighed myself before I went to the post op room.
Just don't say anything.
— Sharon H.
January 7, 2002
I was afraid of the same thing. I wanted to start a workout program to
prepare for surgery but was afraid I would lose too much weight to qualify.
I waited until I was approved then worked out. I lost 15 pounds. They took
my weight my last visit before my surgery, so my pre-op weight is recorded
as 215, not 230. I don't think, though, that this number was ever sent to
the insurance. Once approval came in, the only thing the insurance company
got was the bill!
— ctyst
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