Heres2SecondChances

Send you home to do it yourself... thank goodness! But I still feel grossed out over it. lol.

Twinsies! I'm not looking forward to it either, but my dr lets us eat 1 lean protein a day with a green veggie. I just can't imagine making it on protein shakes only. I have one for breakfast every morning and it goes right through me.

Yes! The coordination or the setup of coordinating all the tests with the various drs. is a part time job!! I LOVE the YouTube videos... it is how I've spent my time since starting the 6 month diet back in September 2016. I'm starting to do some myself.

I had EKG, Chest Xray at PCP's office yesterday. Started the stool sample yesterday and yes, it is invasive and disgusting! Not sure what else the Cardiologist and Pulmonology will be doing.

Awesome! I've dropped 26 and hope to make it to at least 30 by surgery date.

I think my ins co is requiring the cardiologist & pulmonologist clearances. My PCP couldn't believe I needed them. Her nurse told me the same thing & they did one for another one of my surgeon's patients very recently and it wasn't needed. I have no problems in either area. Great idea on using the hernia as a cover. I work in a big office and it has spread like wildfire that I will be out for 3 weeks. I've told my close co-workers (3) of them, but am now starting to regret it. One of them told me, it is your body and your choice who you tell. I don't like being the subject of the latest rumor mill. I completely understand the struggle, I've been in it most of my life. The times I was able to get down in weight all seem like small little blimps. I'm looking forward to a second chance of having a healthy lifestyle.

Hi: Do you only have to go to your PCP for med clearance? I just posted how I wish that was the case for me. My surgeon requires we see a Cardiologist and Pulmonologist. So many appointments in a very short time. I also have to attend a 2 hr group meeting at his office. Dis you tell work why you need time off?

I'm excited and a bit nervous. I have my PCP pre-op appt this morning. I then have Pulmonologist on 4/18 & Cardiologist on 4/20. Then I return to PCP on 4/26 for final medical clearance. I'm worried the PCP won't be able to get that final medical clearance to my surgeon's office by 4/27 (when they need it). It took her 3 weeks to get them the medical necessity letter. I wish my PCP could do all the clearances herself. All this running around only adds to the nerves.

It amazes me they set surgery dates so soon! Are you all ready to go?

Did they do any invasive testing? Thanks!

Cool! Are you ladies all ready to go? I had to scramble on Friday making all my pre-op clearances appointments. It gets more "real" by the day!

So it wasn't a positive call... But, I got on the phone with the insurance company (they wouldn't let me talk directly to the nurse) and we debated the policy language. I got my approval a few hours later!!! I'm super excited

The insurance coordinator at my surgeon's office left a message stating she spoke with the nurse regarding my "case" and had some things to go over with me. She told me to call her back, but it was after hours and she didn't give me her extension to reach her. ARGH! Anyone experience this? Does this mean I may have been denied? I'm trying to calm my nerves, so if anyone has any insight on why the nurse would call, I'd love to hear it (whether it is positive or not). Thanks!

Ok. My surgeon's ofc is now telling me it has to be a distinction facility & he is no longer associated w/ one. I called the insurance and they told me it doesn't have to be. So I am at a loss and waiting to hear back from drs office. Sigh.

Another question for you... did you have to use a Blue Distinction Facility or was any hospital covered? Thanks!

Here is a copy of the policy from BCBS MN that I have: Policy Position Coverage is subject to the specific terms of the member’s benefit plan. I. Adult Patient Selection Criteria The surgical treatment of morbid obesity may be considered MEDICALLY NECESSARY for patients 18 years of age or older who meet ALL the following criteria: Body mass index (BMI) of ONE of the following: BMI of ≥ 40 kg/m2 OR BMI of 35 kg/m2 to < 40 kg/m2 with AT LEAST ONE of the following comorbid conditions: Hypertension refractory to standard drug regimens; OR Cardiovascular disease; OR Type 2 diabetes mellitus (HbA1C of 7 or greater, or requiring medication); OR Obstructive sleep apnea requiring continuous positive airway pressure (CPAP) or other related treatment; OR Obesity-hypoventilation syndrome (OHS); OR Pickwickian syndrome (a combination of OSA and OHS); OR Nonalcoholic fatty liver disease (NAFLD); OR Nonalcoholic steatohepatitis (NASH); AND Patient meets one of the following in order to improve surgical outcomes, reduce the potential for surgical complications, and establish the patient's ability to comply with post-operative medical care and dietary restrictions: Over the past year prior to surgery, the patient has actively participated in an organized multi-disciplinary surgical preparatory regimen with a substantial face-to-face component of at least 6 visits within a 6-month time-frame meeting all of the following criteria: Behavior modification program supervised by a qualified professional; AND Consultation with a dietician or nutritionist; AND Exercise regimen (unless contraindicated) to improve pulmonary reserve prior to surgery, supervised by exercise therapist or other qualified professional; AND Reduced-calorie diet program supervised by dietician or nutritionist OR Prior to surgery, the patient has actively participated in a nutrition and exercise program with a substantial face-to-face component that meets all of the following criteria: Program is supervised by a physician, physician’s assistant, nurse practitioner/advanced practice nurse or registered dietician; AND Participation takes place for a cumulative total of 6 months or longer in duration and occurs within 1 year prior to surgery; AND Components of the program include visits with dieticians and/or nutritionists, Community-based weight loss programs are acceptable alternatives if participation is in conjunction with the supervision of a physician, physician’s assistant, nurse practitioner/advanced practice nurse or registered dietician. AND The patient must be evaluated preoperatively by an eligible licensed Mental Health Professional to ensure the absence of significant psychopathology that would hinder the ability of an individual to understand the procedure and comply with medical/surgical recommendations. The Mental Health Professional must meet the Minnesota Department of Human Services qualifications, as set forth in Minn.Stat. §245.462, subd. 18 (2015). Providers outside Minnesota must be appropriately licensed according to applicable state law. AND The physician requesting authorization for the surgery must confirm that the patient's treatment plan includes a surgical preparatory program addressing all the following components in order to improve outcomes related to the surgery and to establish the patient's ability to comply with post­-operative medical care and dietary restrictions: Pre-­operative and post­-operative dietary plan; AND Behavior modification strategies; AND Counseling and instruction on exercise and increased physical activity; AND Ongoing support for lifestyle changes necessary to make and maintain appropriate choices that will reduce health risk factors and improve overall health.

They require it be within one (1) year of surgery.

Thank you & congrats on being post-op!!! Best wishes!

Right, but the OP said she has BCBS of Minn, which is the same one I have.

Has your paperwork been submitted? I have the same insurance company and am wondering how fast they we'll hear back.

Hi. I'm so glad to hear that! I have BCBS of Minn as well. I do have a question for you. Did your PCP supervise your 6 month diet and how many times did you visit with the nutritionist during that time? The ins. coordinator at my surgeon's office and I read the policy differently. She hasn't worked with BCBS of Minn previously. Thanks,