dstgirl11

Montgomery, Alabama

Meet with the surgeon June 12th and hope to schedule my June surgery date then.

I was required six months of regular weigh-ins, psych exam, nutrition class. The surgeon put me on a 1400 calorie diet and was told by his nurse to not gained any weight because he wouldn't like that. I was under so much pressure, I was literally panic every time I went for a weigh-in. So I know exactly how you feel. My sister and I was going through the same process but in different cities, surgeons, and insurance companies. She had shorter weigh-ins (4 months v. 6) and her surgeon did not require her to lose any weight and she was heavier. Having completing all of those requirements, my insurance company denied me and I went into a depression where I gained back 10 of the 20 pounds I lost. I finally got approved a week ago having obtaining additional documentation for the insurance company. When the nurse called to tell me that I was finally approved, she rereiterated that the doctor wouldn't be pleased if I can gained any weight. Well, I have so I am under pressure to lose those 10 pounds I gained. My surgery is in June, so I will definite have to lose those additional pounds by then. I feel your pain. Good luck!

I have wrestled with this decision myself and didn't know how I would handle this. I started losing weight when the surgeon put me on a 1400 calorie diet. I worked at a school, so the staff and students would see me walking around the halls and eating differently. I won't have my surgery until school is out and I don't think I will tell but a few family members and maybe one faculty member. People still love to point fingers and make snide comments, so I will be let them think that my walking and smaller portion size is doing the trick, which in the long run it is.

I believed my doctor's records for the years that I was under her care showed my prescriptions for high blood pressure. I do have a cpap machine. My machine is over 15 years old, but my sister had to get a newer machine with a chip that they can monitor from the doctor's office.

Finally got approved last Thursday!!!

I have BCBS of Alabama and I was denied last year because I couldn't provide one year of medical records. During that year, my long time doctor moved and I didn't find another doctor. Well, they stated in lieu of those records, a person could send in pictures and a letter of medical necessity. After calling and doing several live chats, they finally approved me. It was such a long process because I had two medical comorbidities, 6 months of weight loss documentation, medical records, and pictures. I guess by calling and requesting live chats worked.

Martinichic, How are you feeling?

LOL. I hope all goes well with you. While I don't wish any type of sickness on you, I know you want this surgery, so maybe sleep apnea can be one of those options.

That is ridiculous. I've had people tell me that have put weights in their pockets to help them. Of course, it didn't work. When I went to my first appointment, the surgeon kept telling me to lose weight and I lost over 23 pounds. On the other hand, my sister went to a different doctor and they didn't tell her to lose anything.

Have anyone ever told you that you snore? or stop breathing when you sleep? I didn't know either until an ex-boyfriend told me. I finally made an appointment with my PCP and she recommend a sleep study. Sure enough, I had sleep apnea. I had to get a cpap machine to use when I sleep. I know that is helping me but I do have high blood pressure.

After I was denied because of not producing records from 2013, they want a letter from PCP and pictures. I finally got the my primary care doctor yesterday and took it to the surgeon office today. I am waiting to see what they will come up with next. Did anymore hear that they are BCBS is going to be stricter when it comes to weight loss surgery?

Thanks because I keep getting the run around. Each time I called the insurance company they tell me to read the manuel. I have read the thing a million times and called. I am just trying to get clarification, which is: do I just send in pictures or pictures and a statement from PCP. Once again, they say read the manuel. I am thinking about asking for another referral or giving up. This is a mess! I guess I will have to save up and pay for the surgery because I have written my PCP asking for a letter to accomplish the pictures and no such luck.

Do you know how many times you can reapply?

I have not been approved because the office administration is not helpful at all. When I tried calling about paperwork to see if the items had come in, she would make nasty comments. Then, they would say they had problems with pictures in the past. They are no help at all. When, I talk with respresentatives at BCBS they say read the manuel. I've read the manuel over and over again and still can't get clarification. So, now I'm trying to see with my PCP will write a letter to go along with the pictures. If she doesn't, then I will just have the surgeon's office to send in the pictures. I'm really lost and this point.

Do you have 3 years of medical records?

I have BCBS of Alabama and I was denied because I do not have 2013 medical records. I was told to send in pictures. I have read their surgery manuel for obesity and it said something about getting a letter from your PCP. Everything is double underline so I'm not sure what this means. Have anymore had to send in picture documentations and did you have to send in a letter, too? The PCP is the one who referred me to this surgeon and he has already sent in documentation the first time.

I have BCBS of Alabama and they required 6 months of documention, too. I had go to the clinic where my surgeon were located to and my weight taken. A nurse had to fill out the forms and fax to the surgeon. Please call your insurance company to get some clarification. I've call many times to ask them questions about this process.