dlsmom1

I first started the process for my lap band surgery in March 2008.  I had all the required appointments (psych, nutritionist), and then started my 6-month qualifying process.  This included 6 months of a physician supervised weight-loss plan (I used Weight Watchers), along with monthly doctor visits and an exercise program.  I was walking 30-40 minutes a day. I submitted all the paperwork in the fall of 2008 (Oct or Nov).  I was denied;  I appealed, and was denied again.  There was possibly one more appeal - I don't recall.  They kept telling me I needed more documentation, although I was following step-by step the outline laid out, as I interpreted it.  I think that because I did not have a long history of adverse health problems (I had only mild hypertension), that this was why I was denied, although I was never told this.  I found out in November 2009 that BCBS revised the guidelines for bariatric surgery (from 6 months supervised to 3 months supervised), so I thought I would try again.  A friend at work (I work at BCBS, by the way) told me to re-submit it before I started the process all over - what could it hurt?  I might get a different person looking at my paperwork.  So I had Dr Eagon re-submit everything, and was denied again, for the same reason as before. I called back and asked to speak with a nurse who could give me the specifics of why I was denied, and tell me exactly what I needed to do to be approved (which I had done before, to no avail).  A couple of days later, I received a call that I had been approved!  (This was the second week of December, 2009)  I called Barnes-Jewish (Dr Eagon) to see when I could schedule my surgery, and was initially told he was booked up till March 2010, & that she would call me with an appt date.  But when she called back with the date, it was January 4!  So here I am!  Healing up from my surgery and doing well 3 days out.