antsmith101

I think you are asking about the list of Comorbidities that Factor into Bariatric Surgery Eligibility if you have a BMI of 35 or greater. Here is a small sample list Serious comorbidities include: Type II diabetes mellitus Obstructive sleep apnea Pseudotumor cerebri Less serious comorbidities include: Hypertension Dyslipidemias Non-alcoholic steatohepatitis Venous stasis disease Significant impairment in activities of daily living Intertriginous soft tissue infections Stress urinary incontinence Gastroesophageal reflux disease Weight-related arthropathies which impair physical activity Obesity-related psychosocial stress You will also need to check with your insurance company if they cover WLS and then check the requirements needed to qualify. Hope this helps. This Forum is also a great resouce and great people that helps. Good luck

Shouldnt be a problem getting one done but like my doctor, he said he never did one before and told me the surgeon should be able to take care of it... but once I gave him sample letter of what is needed, he got it done within a day and faxed copy to surgeon and a copy to me.

Since Blue Cross of CA PPO is coving my surgery on Dec 3rd... I'm guessing my first fill is in Jan. My insurance is changing to UHC PPO. So my question is... UHC PPO will cover fill cost or i gotta pay full cost??

I'm moving to UHC Choice Plus PPO next year and was wondering if they cover fills? If not then what usual cost for fill?

I dont find out Tuesday on what Diet and stuff I should follow... already order couple sample protien drinks to try before big day ;p welcome to the dec 3rd list =)

Thanks all... and great forum with alota info

Hiya Tomecia... ;p invading your post... sorry but we at same page So if the unjury unflavored really.... dont have any flavor then, to me it sounds perfect to be used mixed together in the second stage also. Going to order some sample first then move to the big stuff =P so most of you have it mixed with Water or milk??

I have Blue Cross PPO of CA, I saw surgeon on Nov 8 and didnt know they submitted to insurance and got approved today Nov 16... =P BMI was 47 on date of Nov 8 with long list of problem

Thanks for your info and stuff Chris.... got approved =)

Gotta do alota stuff... before surgery Read... Read... buy... buy.. Read...

I was so worried starting all over on a new insurance and stuff... lol Gotta start on liquid diet soon... find out tuesday on what I have to do before surgery. Thanks... though I would be stressing like you when they send out approval... lol but they didnt tell me ;p

hmm they did say 3 people ahead of me on date of surgery... lol when you starting liquid diet? I got Pre-op stuff on Nov 20th and Seminar so im guessing Nov 21st I start on liquid till Dec 3rd.

Surgery date Dec 3rd 2007

I'm happy to announce that today..... I was approved for Surgery from Blue Cross of CA PPO. I will be reading the forum for more information on Pre-op and Post-op stuff but any information that you can supply that will be helpful will be very greatful. Thanks everyone for your help and great information.

Well... today was just a ordinary day except 1. Taking a short nap after turning alarm off and waking up and its 9:38am (late)(yes I did change it hour back awhile back) 2. racing to work to find out my its only 8:43am. 3. Leaving cellphone in car. 4. Getting Email from Hospital saying....... We have called you couple times to let you know you have been APPROVED#$@#$ and We like to setup preop appointment and surgery day@#$@#$ OMG@#$@#$ I havent complete the seminar (20th) which was my last task before sending information to insurance company and wait for approval. I was also worried cause company switching to UHC PPO with different requirements. So..... Surgery date: Dec 3rd w/ Blue Cross of CA

Here is a sample letter I gave doctor but he redid it in his own format: (Date) RE: (Patient’s Name) (Date of Birth) Dear Dr. XXXX: Mr./Mrs./Ms. (Name of Patient) has been a patient of mine for ___ years. The patient is (height) and weighs (weight in lbs.) with a BMI of ____. The patient has been excessively overweight for (period of time) and having attempted and been unsuccessful at many different methods of weight loss, would certainly benefit from Bariatric surgery. In addition to morbid obesity, the patient is suffering from the following co-morbid conditions: (e.g. diabetes, hypertension, obstructive sleep apnea, hypercholesterolemia, hyperlipidemia, ASHD, exertional dyspnea, urinary incontinence, degenerative joint disease, osteoarthritis, PVD, shortness of breath, etc.) **The patient has tried many methods of weight loss including diet pills (SPECIFIC DATES & LENGTH OF TIME) with (# of pounds lost and whether it was regained or not), Physician administered diets for (SPECIFIC DATES & LENGTH OF TIME) with (# of pounds lost and whether it was regained or not), etc. The patient is limited due to his/her co-morbidities in the ability to exercise but has tried (LIST ALL ATTEMPTS AND AN SUCCESSES OR REGAINING OF WEIGHT). Family medical history is positive for (e.g. Obesity, hypertension, diabetes, hypercholesterolemia, etc.) I feel that my patient would benefit greatly from bariatric surgery as a tool to help lose the excess weight, lessen the co-morbidities and regain a more healthful life. Sincerely, XXXXXX

all i can say is.... WOW thats fast Congrats

Now you gotta check and see if you can get surgery before Jan 08. Good luck and congrats. I got seminar 20th so hope i can send everything in after that... already finished everything else.. i think =p

I'm kinda in the same boat... I'm with Blue Cross of CA, I got almost everything done and hoping that I can get approval and surgery before Jan 1st cause then I move to UHC PPO. Which I might have problems with 5yrd medical record stuff... Good luck and hope you get speedy answer.

Well talked to my bariatric surgeon today and he approved me for Lapband surgery. I gotta attend Seminar/Support Group next and after that..... I'm guessing the next step after seminar is bariatric surgeon for appointment for SURGERY??? And Insurance turn in?? OMG I REALLY HOPE I GET APPROVED>>>>@#$ sleep Test - Done 1st Bariatric Surgeon Appointment - (Approval) Done 1st Dietitian Appointment - Done PCP Approval Letter - (Approval) Done Psych Appointment - (Approval) Done Seminar/Support Group - Waiting (Nov20)

Motocrossgirly did you also write a letter stating that you missing certain year? and if you did can you provide a sample letter? thanks

I'm currently with Blue Cross of CA and next week our open enrollment for insurance starts and they are no longer offering Blue Cross. So now I gotta choose UHC PPO or Kaiser of CA. I finished my Psych Eval (yesterday), sleep Test (have sleep apeana), and just couple more steps then ill be finished to send into insurance. I'm thinking that if I send in the stuff to Blue Cross that they will deny me cause my insurance is ending at end of Dec. So is it best to wait Jan and send it into UHC? or send Blue Cross ASAP? Only problem I have is with UHC is that I don’t have 5year record of BMI 35+ Medical. I have record from 2001 (BMI 37) then 2006 (BMI 42) and 2007 (BMI 46) Medical Record. Was hoping my long list of medical issue and family, would over rule the 5year record. Any help would be very helpful. Thanks

<p>My current Insurance plan is Blue Cross of CA PPO and now its November... which means open enrollment they are only going to offer UHC PPO, HSA, HRA or Kaiser (CA). It don't say anything about Choice or other UHC plan. </p> <p> </p> <p>My PCP has me already tested for Sleep test done (got sleep apeana), Diabetes, High blood, High Cholesterol, and BMI 46</p> <p> </p> <p>Surgeon is Blue Cross and UHC cover but havent told him yet my insurance in switching over cause i just got mail this Saturday that company is switching </p> <p> </p> <p>So what are the requirement for UHC PPO for Lapband surgery? Blue Cross dont require 6month supervised medical diet and i'm hoping UHC dont either because i want surgery now and been on mannnnny diets over 15years.</p> <p> </p> <p>Hope to get some helpful information here from you guys.</p> <p> </p> <p>Orange County, CA</p>

KingJes, you have Blue cross PPO of CA right? How many test did the doctor put you through after your visit and how long did it take to get your answer from insurance? peacebaby, They told you that you have to pay 4200$? Did you pay piror like they asked or you end up paying later? Did Blue Cross of CA PPo also require you to have surgery at center of excellence? Thanks all...

I was wondering if anyone had Dr. Crookes for Lap Band? I live in Orange County and well my doctor refered me to go to USC for Lap Band in LA and was refered to Dr. Crookes. I have checked online for more information on him and they seem positive but not alot.... So im asking here...like Does he help you get your testing and paper work done fast to insurance?? Helpful in working with you after surgery? and?? Is he expensive?? I'm on a limited budget and well... some are like 15-17k and then jump up to 20-25k. I know my insurance will cover most of it (80%) but still 20% is alot for someone that single and not large income. Thanks all...