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@ - What's the verdict??

Generally the documentation begins with your first doctor visit at the center you are having the surgery. Some insurances will take primary care physician data, but usually, in my experience, it starts with the bariatric center. Good luck to you! Keep us updated. I know 6 months seems like a looooong time but I had about a year between my decision to look into surgery and about 8 months from when I first went to the required seminar at my bariatric center. And 8 months, in retrospect, went by insanely fast. I am now 4 days post-op and I am still feeling a bit surreal that it has happened, the surgery is over, and I'm now beginning my new life. Hope this helps.

Thanks!
I called yesterday and they assured me I'll have a response on Monday!
Its going to be a looong weekend!

I gave up on trying to get my insurance to cover it and am in the airport as we speak heading to Tijuana. $6800 for band to bypass revision... I didn't want to jump thru all the insurance hoops anymore.

I completed my last nutrition class last week so I'm now just patiently waiting for my insurance approval.... Super excited

Yes, after 10 day I was approved! Surgery is 6/24!!!

Please send positive thoughts and energy my way. Doc sent records to insurance for approval. I'm super excited!!!

Mine is the 12th, too!

Thank you for the support and encouragement!! Fingers crossed!

I believe work has to let you, in the case of a planned surgery, request or let them know ahead of time! Just FMLA you have to tell them. I don't have to say what kind of surgery at my employer. I just said it's personal but as long as I have an MD note that states how long I have to be out and when I am returning that is all I am required to have. I would ask HR if I were you. We are able to use any time that we have (sick, vacation, etc) I've only have been at this new employer for 8 months when I have surgery, but they have been wonderful about my privacy etc.

It may be scary but it's so worth it in the end. You don't want all the hard work and weight you have lost to go to waste or come back either. Some things are truly worth fighting hard for. I've been battling insurance for 4+ years and I will fight this time as well, as now it's a need not so much a want! Don't give up girl!!

Hello All,
I wish everyone great success with your procedures. It has almost been a year and half for me and I honestly say it was the decision of my life. I have my next check up on Oct. 30 and can't wait to see how much I have lost since May. So far I am down 120 pounds. At least that is what is was in my visit in May. You all can do it! GOOD LUCK!!!!!

So far so good. Pain wasn't bad AT ALL!! Once I left recovery and got into my own room I slept for about 2 hours then I was up walking for me the hardest thing has been remembering to drink so often! It's like the first day u get home u are literally drinking all day long!!

I live in Fayetteville NC. Had my sleeve 8/31. One week ago today!! Yay me!!!!!????

Born and raised in Eastern NC.
ECU '92
Moved to Georgia afterwards......

Love North Carolina!

APPEAL APPEAL APPEAL.... if you are denied you have every right to appeal up to 3x w/ BCBS and most of the time they will take the appeal b/c they know you are willing to fight for it!! Get your PCP and bariatric surgeon to help w/ that process IF you are denied!! I wish you the very best I am fighting w/ BCBS now for my bypass (not a revision though) !!!
Sending positive thoughts!!

I agree with the above statements if they deny you appeal it have your doctor write a letter as well as you write a letter detailing your struggles as well as all the changes that you have gone through to be healthy good luck.

Congratulations on your approval!! How exciting!

Final Post:
To be clear: I have ANTHEM BLUE CROSS THROUGH COVERED CALIFORNIA IN CALIFORNIA!!
every anthem insurance is different. If you have it through a work plan you may have a waiting period, etc. Your requirements could be different. Also don;t confuse this with Blue Shield of California. They are not the same.
Here is how it went for me:
Step One: Called insurance to verify benefits and find out requirements.
40 BMI or 35 with any co-morbid condition
Choose a doctor in their provider list
Go to a CENTER OF MEDICAL EXCELLENCE blue distinction center
Step Two: Found a doctor and hospital combo after lengthy search.
I started with the hospital, by googling the blue centers of distinction list, and I found anthems list online. Then I called the hospital and got the list of surgeons who work out of it. Then I checked the surgeons in my Anthem directory to see who was covered. This took a long time and was frustrating. but I am glad that Anthem is requiring the excellent care that I am getting.
Step Three: I attended a seminar for the nutritionist and a NUT appointment and got weighed in.
I was weighed by my NUT at this time and my weight qualified me with a 40.3 bmi. I was then asked to lose 5% of my weight prior to surgery, which I did.
I was then given a list of my pre-op tests, which were- psych, ekg, blood work, gallbladder and liver ultrasound.
Step Four: Testing
I got right on the tests- this is huge. The pysch appointment took two weeks to come and two weeks for her to submit my report. Don't dawdle on the psych eval- get it scheduled asap because it can take a long time.
Step Five: Checked to make sure all my forms were received.
Once they were, my surgeons office scheduled me to meet with him and to get my surgery date.
Step Five: Met with surgeon and scheduled surgery for 4 weeks away.
I met with my surgeon, he thought I should do a sleeve but I refuse because of heartburn. He is amazing and handsome to boot! They re-weighed me at this time and I had lost weight putting me under 40 bmi, but they only submit the first weight as they had required me to lose weight prior to surgery.
They scheduled me for a surgery date, I was able to choose one sooner but my work schedule prevented it so I scheduled four weeks away.
Step Five: Submit to insurance
My surgeons office submitted my paperwork to the insurance within a couple of days.
Step Six: Insurance Approval
My insurance told me it would take 5 business days to approve my surgery. I called back after one day to check and make sure they had all the paperwork, and they had already approved my surgery and called the doctor to let them know!!
I was approved in 1.5 days!!
My bmi was 40.3
Weight 251 Height 5'6
Insurance: Anthem Individual plan through Covered California (Obamacare), Silver 94
I had NO 3 or 6 month diet requirement.
I had only to tell my surgeon's nutritionist which diets I had tried over my life.
So there you go!!!
If you have the same insurance as me, that's what to expect. Remember to make SURE your hospital is a center of excellence or your surgery won't be approved. Make sure you meet all the requirements and your golden!!

I have Anthem BCBS , no supervised diet. Had my first consultation with the nurse,surgeon, and dietician on 9/18/14, followed by blood work with the lab. On 9/24 I met with the psychiatrist (required) . I had another appt with my nurse,surgeon and dietician again on 10/2 and scheduled my surgery for 11/18! I am just waiting for the approval from the insurance. So far smooth sailing and the representatives at bcbs have been great! Fingers crossed!

It was authorized some time this evening! Yay! I'm going to follow up with my surgeon's office tomorrow, and hopefully get scheduled!

It shouldn't take long, but one thing that I remember someone telling me when I was at this point was, DON'T RUSH IT...when it's meant to happen, IT WILL and you'll be ecstatic!!!! It will be approved when you least expect it and tears of joy will become endless!! Best of luck on your journey!! -Vanessa ????

My surgeon's office submitted for approval yesterday. All is done, so it shouldn't take long, but I'm anxious because if I don't have surgery in early October, I'll have to wait until late November because of schedule conflicts. So, I just keep checking online, hoping status changes from "pending" to "approved".

I was SO stressed thinking they weren't going to submit until Monday, but I confirmed with Cigna that my file has been submitted and all pertinent docs were received! Woot woot! She said it will be a couple of days. I hope so, especially since after 20 yrs with Cigna my husband's company is changing insurance companies the 1st of the year!
Please pray and send positive thoughts for what we all want...a quick easy approval!