culverhouse5

I have had the consult with he doctor, the psych and nutrition appt. I have to get clearance from my PCP, who says I will regret this surgery, and doesn't want to give me the clearance letter. I am hoping to get the letter this week. Then my doctors office will send everything for approval. I have anthem blue cross blue shield. They said it takes about 30 days to be approved. What is everyone else's experience....does it always take 30 days, does it take longer sometimes? What are some reasons that insurance will deny it? I'm so scared I won't get approved for it.....
Thanks!!!

Is your surgeon requiring a pre-op EKG and blood work? If not, he should just examine you and complete the required paperwork regardless of his personal opinion regarding lap band.

The doctors I manage will just do the pre-op exam/testing based on what the surgeon is requiring. Unless you have a cardiac history, it seems that another EKG would be unnecessary. Just my opinion. I would just make an appointment for the pre-op exam then question the need for another EKG and blood tests directly with your PCP. Make him/her explain to you why its necessary. Good luck!

My daughter ran into the same thing with her doctor. They changed her insurance so she has a new doctor and she is supportive, however her insurance won't clear her. As for me, my doctor wanted me to complete my weight loss on my own, but my insurance did not require her clearance. Besides she said it was up to me I have chosen to have the band and go in on the 24th of this month.

It sounds like that doctor likes the money he'll receive from your insurance if he does all the testing. Have you appealed to your insurance and explained that you just had an EKG and they paid for it? It sounds like your doctor is bilking the insurance company. He can get in serious trouble if he is especially if he's dealing with any type of insurance such as Medicare or Medicaid.
If your doctor is still stubborn by all means change your PCP.

Hey Culver!
I have BCBS of IL (Anthem is close to the same benefits I have) It didn't take me very long to get the process moving before I got my approval in a week. It depends how busy the medical team is BCBS. They have there own set of doctors that makes the medical decisions for WLS and or any type of surgery. Ask your doctors office on how quick they get there approval's back. Since it is almost the middle of the year you might have a longer wait. Hopefully that isn't the case and you get approved and have patience! Good Luck on your journey!
-Amine

I guess I should stop drinking it now, so I'm not craving it after surgery. Thank you for the info!