emily111

thanks!! My surgery is scheduled!!!! JULY 16th!!!!!!!!!! I start my liquids tomorrow!!!! :lol: :thumbup:

APPROVED!!!! I just talked to the insurance and they said that as far as she can see I was approved yesterday and I will recieve the letter in the mail and I have until june 2009 to have the surgery!!! ha like i would wait that long!! lol yeaaaah

good news!!! I just got a call today from Patricia...realllllly nice lady. and oh yeah...she told me I'm approved! lol I'm so happy. But I'm still gonna keep my guard up...until that freaking band is around my tummy and they close me up lol

lol im sooo happy for you I hope I get that call!!!!!!!!! I wish!!!!! Im waiting!!!!!!

ugh, I'm totally in the same boat as you right now. I'm actually in North Dakota. But I'm waiting on Tricare Standard to approve me. My doctor's office said they were sending the stuff out. I'm worried I will get denied because my insurance company will probably only do people my age (18-19) in really severe cases. So...who knows. But I have my surgery scheduled and I'm going in for pre-op blood testing and stuff in a day or two. I really don't have to be let down.

Ugh I know what you are talking about.. I am still waiting the dr office said they would send it on friday.. this is after they told me they sent it on tues. So I am just waiting.. but if they deny you (or me) then it will just be time for an appeal :wink_smile:

what is a peer 2 peer?

thats before you do the appeal you can ask your doctor to do a peer to peer (she will know what you are talking about) and then she will call the ins. person working on your file and try to explain why you need this surgery. My doctor said she has only been denied in a peer to peer once. So from what I understand it works pretty good :wink_smile:

I just got the call from the Bariatric Center and she said they sent the info to bcbs of MN last night. So I called blue cross and they said they dont see it yet but thats normal and I should wait a few days. I am sooooo nervous. I cant sleep and I eat more because I am stressed out!!! I have all my plans though if I am denied my doctor will do a Peer to Peer first.. And just to let yall know this is what anyone should do before the appeal my doctor said she had only been denied the peer to peer once since she has been doing them. So if I am denied with the peer to peer I already emailed the obesitylaw.com for the appeal so I am just waiting sick with a headach and no sleep!!! lol I hate the insurance!!! Anyone waiting like I am?

my insurace has a 10 day period they have to respond in. check your policy book on pre approvals or just call and ask how long they have to respond.. I hope they dont say something like 30 days ugh I would have an ulcer by that time lol

I have bcbs of MN and they told me (its also in the policy book) that they only have 10 days to approve or deny. I just gave all my paper work today to the center and now I will just wait Im sooo nervous I am sick really.

wow thanks bxlisa. That really helped I was thinking of doing that. I mean I did everything they asked and I never once thought that the weight history would be a problem. I do have one apt. with my OB dr but my BMI was only 36 like I said before I have lost all the weight in the past I just gain it all back later. I am going to write this nice letter and have everyone I know sign it and include there phone number I will also look for pics even though I never took any when I was over weight if one was taken I would throw it away lol. Good ideals really :rolleyes2: I also decided to have an appeal letter ready so if they deny me I can just say here you go I have been through heck this past 6 months because of them.

hmm i wish they didnt want both but they do lol meanys and yes i lost 60 pounds on WW I also gained it back but I did it at home and bought the WW material on ebay :biggrin:

OK so I did all I am supposed to do. I have my 6month diet also 5 months with a nutrtionist. I did the sleep apt study. I did the phyc eval. I did everything I had to do. So its time to file on the 23rd (my patient advocate is out until then) and I was reading over the requirements for bcbs of MN and it says 2 year weight history. Hmmm why didnt my patient advocate mention this as a big deal? So I call bcbs of MN and they say oh yea that will be a problem if you dont have a weight history. So now I am freaked!!!! I found one doctor apt and guess what I was on a diet at the time and my BMI is 36. Right now my BMI is 41 with no co morbities. I am so scared I will be denied. I know yall know from my other post that my dad just died and I am having such a hard time in general and this 6 month thing has been so stressful I actually gained weight on it. :teeth_smile: SO please give me your experience with this. What happened to you if you didnt have the weight history or history but under the 40 BMI? SOmeone help calm me down please :biggrin: I am so nervous I feel sick and I know all I can do is wait but I guess hear the experience of other will help :biggrin:

I took my husbands insurance through his work just for the surgery. I will file in 2 weeks they made me do the 6 month thing. If I did not want the surgery I would have never took out the insurance because they charge an arm and leg :teeth_smile: But once I am approved it will be worth it!

this is exactly what I am worried about. I will have my 6th month apt for the supervised diet on monday. I am 24 so I dont have any history for the past 2 years at the doctor the only thing I have is when I lost like 20 pounds and my BMI was 36 I called bcbs and asked them could this get me denied and she was like of course you have to have the 2 year weight history. So now I am so scared. I was thinking of writing a letter also.

hmm well it never bothered me to tell ppl I dont go telling everyone but when I do tell someone they are so excited and want so many details it doesnt bother me at all I dont feel ashamed I tell them I much rather this than dieting and gaining the rest of my life until it kills me :party:

my patient advocate told me that some insurance requires that you count 30 days in between each apt. thank goodness they did not have that in mine. I would call the insurance company ask them about that and get them to mail you a copy of the requirements to get approved this is what I did. I am in my 6 month I will have my 6th appt. in a week. I am like you freaking out lol thinking what could go wrong.

you can call your surgeons office and ask them.. but what I had to do is get all the paper work and the letter from my doctor and bring it to the surgeons office. So make sure your PCP wrote the letter get the 6 month notes and have them ready to bring with you to see your surgeon :tongue2:

eyespy.. Im sry that this happened to you also. Really its been so hard to keep going and the stress of all these apointments has been very hard. My dad was only 44 and it was sudden. I took and started a double 6 month diet one with the nutritionist at my bariatric center and one with my dr. because I did not want to be denied. I would really like to get a new doctor like some of yall mentioned but its time to file with my insurance in about 2 weeks. And this doctor I have to drive 1 1/2 hrs to get to the rest are around 4 hrs or more. I live in louisiana. I called a few other doctors but really they dont sound any better. lol just great right. My center is a 5 star bariactric center and blah blah blah.. I guess they just expect me to never ask any questions. I call and they hate to return my calls. My doctor is kinda rude.. lol I talked to some other who used my doctor on this site and they say thats just his personallity. So I dont know if they can just file get me approved and have me on my way I will be happy lol :thumbup:

HI I have BCBS of MN I have done everything they asked. I did the 6 month diet with my last appointment being on the 16th of this month. I have a BMI of 43.. It started at 41 but I gained a few pounds because during this past 6 months my dad died and life has been very very hard. I was told not to loose any weight or I would be denied. Anyways So now its getting close to the day to file and I am sooo stressed. I am worried that I will be denied even though I did all I was supposed to do. So I want to hear from others that may have done all they were supposed to then were denied. Right now I am in the dark because my Doctor I am using is HORRIBLE and the people in his office do not help me at all!! I dont have many options though so I am sticking with them I just want this surgery over with. Anyways someone help calm me down please :wink2: I am thinking to sue the insurance for emotional distress they caused for this 6 month wait lol

Hi I will be having surgery in the South West Medical center in lafayette,la with Dr. Cunningham. I am curious about others experiences with the hospital staff and doctors. How long does it take after the insurance approval usually for them to get the surgery schduled. Also if they filed your insurance for you how long did it take? I am a little woried about using them because they never return my phone calls and my Dr. Cunningham is not very nice. So I am worried but I am to far into it to change hospitals. Any personal experiences will help. Thanks :biggrin2:

Hi,

I did not lose any weight during my 6 month pre-surgery diet plan...in fact I gained a bit.....Will I have a probelm getting insurance approval because of this? Has this happend to anyone?

Leslee

I was told not to loose weight during my 6 month diet I am on my 5th month now and I actually gained 2 pounds I am being told by the center that this is not a problem its only a problem if you loose weight to put you below the 40 BMI. So I would not worry about it

I have am working with blue care network of MI, and they are basically the same, and even though I had 2 years with my doctors office I was denied because I didnt have 6 months with a nutritionist. Ridiculous I know, but I should know with in 4 more business days if going to the nutritionist did it.

hmm well this is the thing my policy ask for a medically supervised diet for 6 months.. Im doing that its the patient advocate who wants me to do the nutristionist also. I feel somehow its for the money. They like to take my money on the side when they can. My insurance company assures me that I just need 6 month medically supervised diet from 1 dr... SO are you seeing 2 different drs for your 6 month? sorry if I am confusing

HI Im 24 Im in my 4th month of my 6 month diet with bcbs of mn. So I am hoping to have my surgery in july. Im not nervous about the surgery only the approval and I think about it all the time. These months are passing sooooo slooooooow. Also because I didnt weigh enough to start I cant loose any weight on my 6 month diet or I wont be approved. Really these insurance companies are horrible!!

Hi I am also having my surgery at southwest.. but cunningham will do it. they wanted me to get the bypass also they dont seem to believe in the band... not sure why. But I am sticking with the band no matter the pressure :cry_smile:

I have bcbs of mn they said they cover Lap Band but I need the 6 month diet. So I am doing it with my reg. dr because she is in my town. My bariatric center is almost 2 hrs away so I am not using there nutritionist. So I am on my 4th month of the diet and my patient advocate is saying that my dr is not taking the notes right and I should drive to see the nutritionist also for 6 months. Even the nutritionist says thats ridiculous. So this is what I am getting to I am so worried that by only seeing my reg dr for the diet that I wont get approved. But I am doing what the insurance asked the 6 month diet. Does anyone have experience with bcbs of mn? I am so excited about this surgery and so worried they will deny me. I guess I just need to hear some experience from others with my insurance :cry_smile: Help ease my mind pls