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Good luck! I hope it all goes well and you are feeling great.

Got bumped up a day today so I will be getting sleeved on Monday, April 25th. liquid diet starts Saturday so having a nice Easter dinner tomorrow night. Happy Good Friday to me!

April 26th here with Dr. Todd Eibes in Des Moines, Iowa! Whoot Whoot!

I also don't talk about the surgery on my wall but do chat and send private messages with other sleevers on my fb page. Feel free to add me. Deb Burbridge Pfiffner

April 26th here! Woo Hoo! Ok....I'm excited but also getting more nervous as it gets closer but I know it's normal. I worry about missing food. I am so used to eating massive quantities of food and I think, in a weird way, I am going to miss that at times. It's weird. But, that is also the reason I am doing this....so I CAN'T eat massive quantities of food!!!!!

Holy Cow! There sure are a lot of us out there! I have been watching a few of you guys for quite awhile and had no idea you were on here too. Here is my link:

In Des Moines, Iowa with Dr. Todd Eibes. How about you?

Got my surgery date today. Woo Hoo! April 26th. I can't wait. Keep the faith everyone. It will be your turn soon!

What I have seen from most people, myself included, is that they did their diet with their doctor and went once a month for how ever many months are required by their insurance companies. I also believe that say your insurance is a 6 month diet, that it is actually 6 visits, which is actually only 5 months, not actually 6 full months. If that makes sense.

I was denied because they said my doctor and I didn't discuss exercise enough during the supervised diet. We did discuss it and both he and the surgeon's office felt his notes were sufficient but they still denied me. Also, my BMI is over 50. I think you just never know what they are going to say. What I ended up doing was writing a letter with all the reasons I felt I needed the surgery, which included all the diets and exercise plans I had been on over the past 30 years and I sent it to them. I also noted what exercises I had been doing and how often over the past two years. I made sure I gave a TON of detail in this letter They say they will take any additional information you have and will review it if you are denied. I did not file an appeal, just submitted the letter after I got my denial letter. Shockingly, it worked and they approved me. I was very surprised. It might not be a bad idea to include a letter with your initial paperwork and see if helps get you approved. I think the more information you give them, the better.

I just think you never know for sure what's going to happen. I wonder if it just depends on who reviews your information. My info was submitted when it was a 3 month diet requirement. I had done a 5 month doctor supervised diet and also submitted 2 months of weight watchers weigh ins (weighed weekly) and I got denied. But, I hear other people say it was a piece of cake for them so I think you just never know. Maybe sometimes people are cranky when they are reviewing them or something!

OMG you guys. You are not going to believe this. Ok...so I was denied in February becuase they said my doctors notes did not show that we had discussed exercise during my doctor supervised diet so my surgeon's office wanted me to redo the three month diet. Then the plan changed to six months. I was really, really down about it but decided I would go ahead and do the six months since I really didn't have a choice. I kept calling and getting advice from their customer service representatives and they kept saying if I could submit any additional information to please do so and they would review it. So...I decided to write a letter detailing my lifelong battle with my weight. I included all the diets and exercise programs I had been on and also informed them of the medical issues I was afraid of getting in the near future. I really didn't hold much hope that it would work but I figured what do I have to lose? Guess what????? I just found out this morning that I was approved! I cannot believe it! For those of you out there who are feeling down....don't give up. I was feeling really low but didn't give up and I made it work! You can do it too! Don't let them get the best of you.

It seems like it is hit or miss with them. I also attended a support group meeting, met with a dietitian, psych eval and actually did a five month doctor supervised diet and still got denied. I am not giving up hope though.

[Leesey- where did you go through to get the $4500 price?

Yep. I just called and was told it changed to 6 months also. I asked why I had been told by several people there that it was not changing and they had no answer for me! Of course.

Sounds like we are in the same boat. Mine was submitted but they felt it was not detailed enough about the exercise portion so we are redoing the diet. I am sure going to make sure we talk about diet and exercise both in depth at my appointments. I don't want to leave anything to chance! I think I might write a letter to be included too. I've been this way my entire life and have been on every diet and exercise plan known to man. I wish they would take that into consideration.

I have called twice now to check on the change to a six month diet. I did verify that it does say this on their website and it says it is changing 3/15/11. I called twice and have been assured both times that it is not correct and there is not going to be any changes made. Fingers crossed that they are correct!

I just called my insurance company to check on this change. I definitely do not want to have to do a six month diet if I don't have to. They assured me that there is no change planned as of right now. She said that if a change is being made, they give them several months notice and they have not received anything saying anything like that. She said that maybe it is a new requirement of your policy but from what she could see on mine, there was not going to be a change! Hopefully she is correct.

Well, I have good news and bad news. It only took them one day to decide whether or not they were going to cover the surgery (went to review Monday and had decided by Tuesday). The bad news is...they denied me. The reason was that they didn't feel my doctor and I discussed exercise enough during my doctor supervised diet plan. This doesn't even make sense to me since they say they accept Weight Watchers and Jenny Craig diets, which are eating plans. They would have no way of knowing if you discussed exercise with your Weight Watcher leader or not since you just turn in your weight book for proof of the plan. I am frustrated and think their reasoning makes no sense but.......my surgeon wants me to do the diet again and make sure we specifically discuss both diet and exercise in depth so that is what I will do. It's actually three visits, which is only two months and I can live with that. It's been so long already, what's another two months??!?!?! I can do it.

Wow! Great job to both of you. I can't wait to see the pics for the next 30 lbs lost! I'm sure it will be here in no time.

Unfortunately, my BMI is around 50 so I shouldn't have any problems there. It is my understanding that they use your starting BMI. Here is the info they sent to me a couple of weeks ago. This is specific for my policy and am not sure if they are all the same:

Thank you for your inquiry. Medical record documentation of active participation in a clinically-supervised, non-surgical program of weight reduction for at least 3 months occurring within the twenty-four (24) months prior to the proposed surgery and preferably unaffiliated with the bariatric surgery program. [NOTE: The initial BMI at the beginning of a weight reduction program will be the "qualifying" BMI used to meet the BMI criteria for the definition of morbid obesity used in this policy.]

A program will be considered appropriate if it includes the following components:

1. Nutritional therapy, which may include medical nutrition therapy such as a very low calorie diet such as MediFast or Optifast OR a recognized commercial diet-based weight loss program such as Weight Watchers, Jenny Craig, etc.

2. Behavior modification or behavioral health interventions.

3. Counseling and instruction on exercise and increased physical activity

4. Ongoing support for lifestyle changes to make and maintain appropriate choices that will reduce health risk factors and improve overall health.

I think your three visits will be fine. They are still three visits each a month apart. Three months is really only two months period of time. I don't think you have anything to worry about. I actually did five doctors visits because I used to have a different insurance that required six visits but now only have the one insurance, which only requires the three. Another thing for you to consider is that if you did anything like Weight Watchers or Jenny Craig within the past 24 months, you can also submit that information. So, all in all, I submitted five doctor visits and two months of Weight Watchers books. I don't think you should have a problem but if you are worried and have any other diet plan info, be sure to include it, just in case!

Good Luck!

Deb

Great Job! Nowhere but here would anyone understand being excited about being categorized as "obese"! I love it! Next, you can look forward to being "overweight"!

My info was submitted to BCBS Illinois on Wednesday, 2/16. I called today and it had been received. The rep I spoke to got all the info together and sent it to review while I was on the phone with her. She said it takes up to 14 business days for an answer. I will let you all know how long it takes for me so people may have an idea for the future if they also have BCBS Illlinois. After approval, my surgeon says surgery will be scheduled for two weeks later! Woo Hoo!

Good Luck to you! Sounds like you have done your research and are ready to take it on. It seems to be normal to be apprehensive of the unknown but I know you will do great!