lolarose13

So i just called and my insurance said that my revision has been approved!!!!!!!! PTL! I'm still in shock and waiting for the official call from my doctor.! Sent from my iPhone using the BariatricPal App

New update: So after hours of taking back and forth with the Insurance and doctor's office, I finally understood what happened with my records (they submitted more than a week ago, but nothing was filed with my insurance until today) So my doctor's office sends everything to a "predetermination" departament of Blue Cross Blue Shield to verify (in written) that I have coverage for bariatric surgery. This predetermination process is voluntary, but I guess my doctor thinks is worthy, so they "submitted" to the insurance just get a determination of benefits. This single process can take up to 2 weeks. Once this departament says ok to the coverage, that's when they finally send the records to my actual insurance for precertification. Gosh, I wonder why they didn't explain this to me from the beginning. So be aware that this is a common practice, so if your doctor takes this route, it will take much longer than what your own insurance told you. Finally, my insurance received the predetermination (benefits only) and records today. Praying for an approval! Sent from my iPhone using the BariatricPal App

So after hours of taking back and forth with the Insurance and doctor's office, I finally understood what happened with my records. So my doctor's office sends everything to a "predetermination" departament of Blue Cross Blue Shield to verify (in written) that I have coverage for bariatric surgery. This predetermination process is voluntary, but I guess my doctor thinks is worthy, so they "submitted" to the insurance just get a determination of benefits. This single process can take up to 2 weeks. Once this departament says ok to the coverage, that's when they finally send the records to my actual insurance for precertification. Gosh, I wonder why they didn't explain this to me from the beginning. So be aware that this is a common practice, so if your doctor takes this route, it will take much longer than what your own insurance told you. Finally, my insurance received the predetermination (benefits only) and records today. Praying for an approval! Sent from my iPhone using the BariatricPal App

I have this exact same issue! Lady at the doctor's office told me that they submitted last Monday and the insurance said that they haven't received anything! They called to the doctor's office and they said they submitted on Tuesday (they lied to me then!) but as of Friday nothing was submitted. I have a case open so the insurance will call once again tomorrow. The lady at the doctor's office never answers my emails and I have to drive all the way to their office to get things done. So awful. Sent from my iPhone using the BariatricPal App

Praying for you! I'm also waiting for insurance approval! Sent from my iPhone using the BariatricPal App

Still waiting. I called BS of CA and according to them, they haven't received any records from my doctor. The insurance rep called my doctor's office last Wednesday to verify and gave them their direct fax number to resubmit the records, but as of last Friday, the insurance was still waiting to receive the records, Sigh. I'm hoping that this was just a mixed up and the records are submitted but not showing in the insurance's system, otherwise I lost an entire week Sent from my iPhone using the BariatricPal App

I have BS of California PPO Plan (through trinet) Sent from my iPhone using the BariatricPal App

Now the waiting is on. I submitted all the paperwork to get a conversion from lap-band to sleeve. I did everything they required and I pray that everything goes well! My only concern is my BMI. It is 35.5 BMI but they need only 1 commorbities (I have GERD, PCOS, Diabetes type 2, depression, anxiety, and high cholesterol). I hope this is enough for them Prayers are super appreciated! I will keep you posted. Sent from my iPhone using the BariatricPal App

Thank you for info. Please keep me posted on your progress. Im going through an Institute of Excellence as well. They did mention that I will have to go through all the requirements again. How long ago did you start the process? Hi, I did my 6 months of nutritional visits last year. I started to request medical records on March of this year and I had my first consultation with the surgeon April 12. After that, I took 2 mandatory classes and I have my psychological evaluation done 2 weeks ago. I received the results of the evaluation yesterday and my doctor is submitting to insurance today or Monday. Do you know your insurance requirements? Some insurances do not require the 6 months diet, so the process goes a lot faster in this case. Sent from my iPhone using the BariatricPal App

Wow!!!! You look so beautiful!!!! What an amazing transformation!!! ❤️ Sent from my iPhone using the BariatricPal App

Lol. Sent from my iPhone using the BariatricPal App

I'm submitting to insurance Friday, and if everything goes well, I'm hoping to get schedule for June! I'm so nervous! Sent from my iPhone using the BariatricPal App

I'm going through the process of having a revision surgery. I lost 20 pounds with the lapband but I had complications. My surgeon told me that he can not perform the revision if my BMI was lower than 35. Long story short, I had to gained all my weight back and start from 0 in order to qualify for a revision surgery. I'm at 35.5 BMI right now and I have several health problems. My insurance and surgeon require documented lap-band complications and compliance with follow-up Lapband appointments (for the Lapband removal part), at least 35 BMI and 1 comorbidity, 6 months diet, pschy evaluation, documented active methods of weight loss (gym memberships, etc), 1 surgeon visit and 1 NUT visit. I'm submitting to insurance this week. I'm going to a center of excellence so their requirements are super strict. Every surgeon is different and I hope you can find one that help you through this process, good luck! Sent from my iPhone using the BariatricPal App

Mine would be $18,000 in Arizona if I get deny by insurance (Lap-band revision to Sleeve). Praying that my insurance will pay. Sent from my iPhone using the BariatricPal App

This is exactly my story! I'm so glad I found this thread too!. My BMI finally hit 35.2 at the time of the consultation and I have PCOS, diabetes type 2, high cholesterol, depression, anxiety and controlled hypothyroidism. Hopefully, my doctor will submit my paperwork to the insurance tomorrow and I'm so nervous! My surgery is a revision from LapBand. I lost around 30 pounds with it, but I had so many complications that I need to have it removed. Unfortunately, my insurance wouldn't pay for the revision with my low BMI. So I had to gain all my weight back and start over. I'm so nervous that they would deny me! Prayers are appreciated!

I'm waiting for my psychological evaluation results and we will submit to insurance. Dr. Juarez is doing my revision. Everyone at Bridges and St. Luke's hospital is really nice and helpful. Loving it so far. Sent from my iPhone using the BariatricPal App

I went today and they took all the saline out my band. I feel so much better now! Sent from my iPhone using the BariatricPal App

Thank you for your answer! About your question, I talked to my doctor about having the lap band removal and revision at the same time and he said that he usually does the removal and sleeve in the same surgery. However, he told me that it depends of how much scar tissue you have around the band. If there is a lot of scar tissue, he will only do the removal and schedule the sleeve surgery for 6 weeks later. Sent from my iPhone using the BariatricPal App

Hi! I was wondering if Un-filling the band pre-surgery is necessary. I'm submitting all my papers to the insurance this week and I was wondering if I should request an unfill in order to prepare for the surgery. Right now my band has 5.5 cc of saline. How was your experience with your revision? Thank you! Sent from my iPhone using the BariatricPal App

Hi @Chaelove! I have my first appointment with Dr. Juarez from St. Luke's next Tuesday. Good luck with the insurance approval! Sent from my iPhone using the BariatricPal App

Have fun!!! ️ Sent from my iPhone using the BariatricPal App

Thank you so much @@kmorri! Your explanation was perfect and it makes so much sense! I will definitely call them to verify everything. Thank you again! Sent from my iPhone using the BariatricPal App

Hi Azpete! Do you remember/know your insurance requirements? I'm going for my consultation and I have BS of CA, but they said that since I live in Arizona and they surgery will be in Arizona, I need to follow the BCBS of AZ requirements! (?) I'm super nervous about this Sent from my iPhone using the BariatricPal App

Hi @@reachbree! Crossing fingers for you! I also have Blue Shield of CA and I'm so nervous! I'm barely 35 BMI, with PCOS, high cholesterol and insulin resistance and I'm trying to get a revision from lap-band to sleeve. I'm having so many problems with the Lapband but I'm super fearful they are going to denied the approval because my borderline BMI Sent from my iPhone using the BariatricPal App

Hi! I'm 4'11 and waiting for my first appointment to get a revision from lap-band to sleeve Sent from my iPhone using the BariatricPal App