Kmarie:
BCBS of AL has been approving the Lap-Band surgery since April 2007. However, you have some hoops to jump thur.
1. Your BMI must be over 40 or over 35 with at least 1 of 3 qualifiers (Sleep Apnea, High Blood Pressure, Diabetes). My BMI is over 40 and I have Severe Obstructive Sleep Apnea (OSA) and High Blood Pressure. Due to my OSA, I have a trach.
2. You must have maintained a BMI of 35 with qualifiers or over 40 for the last 3 years. This is will be checked and verified by your surgeon & BCBS thur copies of your medical records you must have submitted by your doctors to the surgeons office. I was able to have my sleep doctor, my ENT, and my family doctor submit copies of my medical records for the last 5 years which I think helped.
3. If you meet 1 & 2, you must now complete at your expense a 6 month doctor directed diet with your family physician. During the diet, you must maintain a exercise and food journal to document your success or failure of the diet. This stage will require 7 monthly visits, scheduled at least 30 days apart with your family doctor. This is key as BCBS requires at least 30 days between each visit or it does not count. It cost me about $500 to complete this phase. I finished in December 2007. My family doctor knew why I wished to complete this diet program and was very supportive and understanding. My sleep doctor and ENT want me to get this surgery to help with my OSA.
4. Once complete with the diet, your surgeon can submit your paperwork to BCBS. BCBS will then require a consult with a physical therapist and a nutritionist. These consult visits are to teach you the exercise and diet plans you must follow prior to and after the surgery. I just completed this phase last week. I spent an hour showing I could do the exercises with the PT. I then went and spent the next hour learning how & what to eat. I am putting it to practice now. They say it takes 40 days to make or break a habit.
5. After the consults, your surgeon will re-submit the paperwork with the reports from PT and nutritionist. Now is the time to sit back and wait on BCBS. My surgeon tells me the approval can take any where from 24 hours (if submitted on-line) to 10 days. I am awaiting my surgery date. I hope to have a date later this week. I would think my surgery wold be sometime in February.
6. Final step is to get the surgery and start life a new.
I am using Dr. Britt of Marshall Surgical group from Guntersville. They provide a free seminar monthly at the Madison Surgery Center on Lanier Road in Madison, Alabama. They have surgery rights at the surgery center, Crestwood in Huntsville, Marshall Medical North in Guntersville, and Marshall Medical South.
I see you were planning on attending a seminar. Have you attended? Where do you plan to have this surgery?
Andy