doingitforme29

Does anyone have LG BCBS of Alabama? If so, I'm interested to know about your experiences with them and the approval process. I'm currently awaiting approval for the VSG and I've been extremely stressed about it. My surgeons office submitted dated photos along with the pre approval documents. It was either 3 years of height and weight records it dated photos, we chose dated photos. Has anyone else submitted pics for approval?

I like the pineapple coconut flavor enhancer made by Dasani

I work two jobs. I returned to work one week post-op and barely made it. I could only stay 1/2 day. I was still experiencing discomfort and felt extremely tired. As of yesterday (12/22/14), I returned to work full force and I'm doing well. Any of you on your puree diet yet?

I received my approval letter today!!! I have an appt with my surgeon this friday, in which I have to do a weigh-in and schedule a surgery date.

Like you, my BMI didn't climb to 40 until the last couple of years. Instead of physician documents, I submitted dated photos. I didn't have to get a letter from my primary physician. My paperwork had already been submitted prior to my recent gyno appt, however,after telling her about my decision, she provided my surgeon with documentation to support my need for surgery. I am also seeing Dr. Malipur. I found out I was approved today. I have an appt this friday for a weigh-in and to schedule a surgery date.

Gain approximately 5lbs! It should increase your BMI. Also, look for any health issues you might have such as anemia, asthma, etc. After your BMI reaches 40 submit dated photos for the past three years instead of physicians records.

I have local government employee BCBS of Alabama. It covers 50%, and I'm required to may the physician's fee, which is $1,057.00. I'm just hoping to be notified soon. I've been really stressed about it. Most insurances require 6 months of supervised dieting and seeing a nutritionist, I don't have to do that, I guess it balances out since I have to pay the physician's fee. My surgeon requires that I take a nutrition and pre-surgery course and attend one support group prior to getting a surgery date.

@Monasongbird_38" Really!!??? Congratulations!!! It will be three weeks on Friday since my my surgeons office submitted my paperwork! I haven't heard anything since my initial denial letter which was expected because my dated photos were submitted a day after the other paperwork. How did you find out about your approval? Where in Alabama are you located? Who's your surgeon?

Oh, wow! I definitely don't want to have the band and still be hungry. I've decided to get the sleeve if my insurance approves it. It's been a week since my surgeons office submitted my to insurance.

I'm sorry things didn't work out with the band. I was actually contemplating getting the band but I'm leaning towards getting the sleeve. What lead you to hate the band? What other problems or complications did you have?

Thank you for responding to my post. I've been checking the mail daily and anxiously awaiting a call from my surgeon's office, hoping they have received my approval. I'm so nervous, it would be devastating if they were to deny me. I'm being very optimistic and praying for the best. I've been contemplating between the lap band and they sleeve and I've decided on the sleeve (I think). It took some time for my husband to become supportive of the lapband, so I was nervous today when I revealed my decision to get the sleeve to him. To my surprise, he was ok with it and stated he wanted me to be happy. The only person who hasn't been supportive of my decision is my mother. Did you have any issues with anyone not supporting your decision?

I received my initial denial letter yesterday, which the nurse told me it would happen. She basically explained to me exactly what you mentioned about the claims process being automated. She told me she would submit the claim that day, and that would automatically trigger the denial because the pics couldn't be sent until the next day. I'm currently awaiting approval. I'm so stressed about getting approval.

@ onephatmom My insurance only requires me to submit three years of height and weight records or dated photos. I submitted dated photos to my surgeons office yesterday and I'm just awaiting approval. The downside to the minimal pre approval requirements is that my insurance only covers it at 50% so we're looking at 1057.00, which isn't too bad. Are you getting the sleeve or the band! I'm praying I get approved!!!

@@peachpie1 what influenced your decision to get the sleeve instead of the band? I'm doing the research and I'm really torn between the two. My husband is very supportive of the lapband for reasons such as: it being reversible, less invasive, and doesn't require a long waiting period to start trying to conceive, and doesn't produce a drastic weightloss. He is adamantly against the sleeve as he thinks it will make me lose too much weight.

Hi. I've been going through this process for approximately 2 months, but have been wanting this surgery for over a year now! I had to postpone thing because I went through a phase without insurance due to relocating and a job change. I'm currently awaiting approval from my insurance company and Im praying they approve my surgery. This is something I'm very committed to doing. My only issue is deciding between the sleeve and the lapband. My current weight is 230lbs and my goal weight is 165/170. I don't wavy the drastic weight loss of a sleeve nor do I want to wait to have children for 2 years, but I do want something that guarantees results and long-term success.

@ planningband07 @@MarieMarie ⬆️⬆️⬆️⬆️⬆️

Well..... My appt went great yesterday! I met with the surgeon, submitted dated photos, and I'm currently awaiting insurance approval, which they're pretty confident about. They've already given me a check list of things to do before they will schedule my surgery date! This surgery center has a 90% approval rate with insurance companies and is accredited by the bariatric center of excellence. My current dilemma is deciding between the lapband and the gastric sleeve. The surgeon recommended the sleeve because according to research 70% of ppl with lapbands either fail or end up getting the sleeve. I'm actually nervous about the sleeve. It's permanent and causes drastic weight loss (90-100lbs). My goal is to lose 65lbs which will put me at My goal weight of 165! My husband thinks a sleeve is too drastic and my best friend said I would look like a "blow pop," meaning big head, small body. My concern is that the lapband might not be as successful as I would like, but the band will make me lose too much weight! I just want to make the right decision and not have to end up having another surgery in the future. Decisions, decisions! Also, my husband and I would like to start a family sooner than later, he's 32 and I'm 29! With the sleeve, I would have to wait two years to have a baby making us 31 and 34! Advice anyone?????

My only concern is that my records have me being 5'3 and my BMI increased to 39 and has recently become 40.3. My comorbidities include hypertension, fatigue, and constant weight gain. My menstrual cycle has been irregular for the last three years, which I think is because of the weight gain. Is that enough to get me approved? I've been really stressing about it since my appointment with the money hungry surgeon from hell. My husband thinks it was gods way if preventing me from going to a surgeon who didn't have my best interest in mind. I'm hoping this new surgeon helps get me approved. Hopefully he'll include pictures as well. I'm stressed but excited to be going to a new surgeon.

Thank you so much got your feedback. I didn't think of it as gods way of preventing me from going to the wrong surgeon. I can't help but think that the dr didn't bother requesting my medical history from my previous physician or anything. He didn't even emphasize what I needed to do to get insurance to pay neither did his staff. They were adamantly telling me to finance it through care credit. Immediately after speaking with the nurse at the dr my insurance company referred me to, they were very optimistic, asked me to get my medical records, informed me of the option to use photos, etc!! I received my medical records from my previous physician and every document has my height listed as 5'3 contrary to what the dr claims I was yesterday. I have been 5'3 since high school. That alone made me feel as if that dr didn't have my best interest in mind. I'm scheduled to attend the preferred dr's seminar or September 2nd and hope things improve from there.

Well today I had a consult with a surgeon who specializes in bariatrics. I was weighed in at 229 lbs and a height of 5'4, which makes my BMI 39.3. Firstly, I've always been measured at 5'3. The surgeon stated I was a great candidate for the lapband procedure but stated my insurance would not pay because my bmi isn't 40. He stated my insurance requires my BMI to be 40 or 35 (with a co-morbidity) for the past three years. He did not see what could be done to help me qualify nor did he request to retrieve my medical records from my pcp or other physicians. I immediately contacted my insurance company and they stated they do not have to have pre authorization, but there's a possibility they may request info in the future and if they find it was not medically necessary, they would withdraw the benefit. My insurance company gave me the info for a doctor who has a 98% approval rate. I do not have any comorbidites other than asthma, very infrequent menstrual cycles, and infrequent high blood pressure. I spoke with the staff at the doctor's office my insurance company referred me to and she was very optimistic about being able to help get me approved. I prayed before I went in the doctor's office asking God to reveal the best option to me, I can't help but wonder if I'm going against God's answer to my prayer by seeking approval through another physician. Having this surgery is very important to me. It's something I have desired to do for the past three years. I really want this. I know of a lady who has the sleeve and was denied twice before she received approval. How often do people get approved after being denied. I wasn't denied by my insurance company. The doctor simply didn't try seek approval from my insurance. The moment the calculated my BMI and saw that it was 40, they were pushing me to finance the procedure. Advice anyone. What should I do? How do I get my insurance to pay?

Is there anyone who has been/is concerned with losing too much weight?!?

"jlj1110 I hope they gain a little more understanding. My husband was a little reluctant to approve/support my decision until I educated him. While I don't value the opinion of my in-laws, the support if my husband and immediate family is the most important. So I understand how having your Inlaws support would be so important.

@@planningband07 I hope you're feeling much better! What kind of pain have you been experiencing? I'm really excited about the possibility of having surgery. I just keeps goals in mind to prevent anyone from discouraging me. People are so quick to call it the easy way out, but they don't feel how we feel or have any similarities. Wishing you a speedy recovery.

I'm scheduled for my first consult this Wednesday ( August 20th), and it can't come quick enough. I'm so excited, I really hope things go well. My BMI is 39 and they've already been told that my insurance doesn't require the 6 months of nutrition consults etc, which is a plus! They estimate it will probably be a month before it can have the surgery if I am approved. I haven't shared my desire to have the surgery with anyone other than my husband and my best friend. After recently gaining the support if my husband (he had to be educated), I informed my brother of my decision and I was taken back by how supportive he was and he offered to help me work out when my husband is unable to do so. So far, things keep getting better and better! I've decided not to tell my mother until after I've been approved and have a surgery date. I fear telling her because she doesn't agree with it and has voiced being against it when I've mentioned it in the past. Suggestions anyone?

He has become more understanding after educating himself on the procedure. His concerns were legitimate, but I'm extremely happy that I have gained his support. He simply doesn't think I'm overweight and need surgery. He asserts that he loves me the way I am, but I'm "doing it for me." Thank you so much for your support. I am amazed at how supportive everyone on this forum is.