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getting my ducks in a row.

Hi, my name is Sandra and I am totally new at this. I am in the process of starting the Journey. I haven't even had my surgeon meeting yet. I have BCBS federal standard insurance and my bmi is 47-48 so I am sure they will cover the surgery. just waiting on their conditions.

5 Comments

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RAAinNH

LAP-BAND Patients

"a journey of a thousand miles begins with a single step"

Congratulations on your decision to start a healthier lifestyle!

Neuanfang

Gastric Sleeve Patients

Welcome and you definitely found the right place. Ready... set.... go !

SqueakyWheel&Ethyl

LAP-BAND Patients

Congratulations on making this choice and props to you on taking action now! Here's some unasked-for advice.

Not knowing how BCBS responds typically, but knowing how my insurance resisted, I strongly recommend keeping a journal of each interaction pertaining to this surgery, with insurance, with Drs, nutritionists, etc. if you use a computer a lot, use it. I kept an electronic journal in Microsoft Word. I logged the date, and just wrote brief broken sentences that cut to the chase, like,

"09/12/12. Phone call w/insurance rep, Bianca L. (936-999-9999). Requested list of criteria required to get insurance approval. She will email it to me by 2 pm."

"10/04/12. Met surgeon, Dr B, on 1st appt. Was set up with monthly appts with Nut Counselor for 6 months."

"03/17/13. Pre-op appt with Dr B. Scheduled surgery 4/17."

Keep track of what BCBS requires yourself. Don't rely on them or the surgeon's staff. Do they require months of nutritional counseling? If so, how many? Do they require a psychological evaluation? Do they require a 6-month log of what you ate every day? Will they want to see your Dr's records showing what your weight has been over the past 3 years? And, don't take for granted that your PCP (primary care physician) and surgeon are shaking hands smoothly on everything. If you call and verify the PCP provided the necessary records, and confirm the surgeon's staff received it, things will go easier and quicker.

And, if your insurance requires several months of counseling, don't despair. I learned a lot in those appts and the time allowed me to really make peace with this permanent lifestyle change. By the time they wheeled me into the OR, I was so happy, as soon as my gurney crossed the OR threshold, I raised my fist in the air and pulled it down fast yelling out, "YES!" I worked hard to arrive at THAT moment and I marked the success with a mini-celebration. I was soooo ready!

We are all here on this site to exchange ideas, questions, and reassurances. If you haven't yet, fill out your profile. Post a before picture. Take your measurements the night before surgery. There will be times your weight loss will stall, but the inches will continue to melt away.

Good luck on your journey!

sandiclaws4

Gastric Bypass Patients

SqueekyWheel... Great advice.. thanks.

sandiclaws4

Gastric Bypass Patients

I am at the very beginning. I haven't done anything but go to the seminar. I have started a 3 month diet with my pcp. I also had him write me a letter. I have a great team at the hospital I am going too that coordinate everything. I will be talking with them Tuesday. I don't have my days off together so I have to work it out on them. The hospital is a Blue Distinction Center. I have a patient advocate that is walking me through the process. I am learning on the go so any advice is greatly appreciated. I am so nervous about the sleeve...asking myself will it work? will it be enough? how will I be able to maintain the weight loss after a number of years. just nerves. there aren't any long term studies so I feel like I am taking a leap of faith.

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