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Having Anxiety Over Approval Decision.



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Hi All...

I just finished the required 6 months of "weight check" appointments and submitted to my surgoens office . My BMI is now 37. I gained 6 lbs during this 6 months period since I haven't been to the gym as much with school and work. I have PCOS, high cholesterol, GERD, hiatal hernia, depression, a mild form of sleep apnea (doesn't require CPAP, instead I wake myself up in my sleep before my airway is obstructed about once an hour, my sleep specialist said this would improve with weight loss). The only thing I take medication for is PCOS. I have Empire BCBS and the nurse coordinator had submitted all my paperwork from the weight check appointments to insurance company either Friday afternoon or on Monday. Every minute of my day is consumed with wanting to know if I will be approved. Since I do not have high blood pressure or diabetes, I have anxiety that I will not be approved, especially since I gained 6 lbs during this period. I'm so eager to have the surgery that I'm afraid I'm setting myself up to be really crushed if I get denied. I feel like it could go either way with the approval. Anyone with a similar situation? Anyone with Empire BCBS?

<3 lisa

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I had no medical issues aside from the fact that I was very overweight. So like you I was afraid I wouldn't get approved. But I went through the motions and got approved. If your doctor strongly recommends it and have reasons why you need it hopefully you will get approved. I also have PCOS also and BCBS.

I hope you get approved!

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I'm waiting for my approval also. I don't have diabetes or high blood pressure either so I do have that worry of not being approved. Our insurance isn't very strict on terms of having to be on a 6 month diet or anything like that but I do still worry. I finished everything I needed to do last week so I'm waiting on the insurance, they said it could take 4-6 weeks. To me, waiting is the hardest part. Good luck, I hope you get approved quickly! :)

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Shannon28 -

I don't have BCBS, I have UHC but I had a BMI of only 35 with High Blood Pressure and High Cholesterol. My paperwork was submitted on Tuesday of last week and they told me it could take 4 - 6 weeks, just like you. I called on Friday and my insurance told me I'd already been approved! I didn't think I would get approved with that low of a BMI and I certainly didn't think it would be that fast but it was! I saw your post and hadn't even made my own victory post yet so I thought I'd post in here and give you a boost! If you dying to know, you can always call your insurance company occasionally and check on the approval just like I did. Keep your head up and fingers crossed!

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Thanks so much for the words everyone :) I hope we all get approved. I'll try to call my insurance after a couple days pass next week. Hopefully we'll all have some good news soon!! I never dreamed I'd ever be so freaking excited to do a two week liquid diet, but I can't wait.

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I to had no medical reasons for needing the band other then i was very over weight..I did the 6 month dieting...and all the other test they asked for...my doctor submitted to insurance and I was approved in 2 days The doctor called me to tell me...i cryed I was so happy!!! But those 2 days were the longest i have waited in a very long time....Good Luck to everyone !!!

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I have bcbs-il and I have been required a 6 mos of what they call Wellcare which was phone calls. I am on my 5th month. They are suppose to call me back for my last phone call in March. They told me the last time i talked to them they would talk to me that time bout what i would need after surgery. But they have to then turn it into the insurance to get approved. I am told this only takes a couple of weeks. I so want to have my surgery the last or april first of May. I am to very anxious bout not getting approved after geting my hopes up.

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I gained during my supervised diet(3mos) with Aetna and I have no problems except overweight. they approved me in 2 days.

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Just a thought for anyone still in the process of supervised diet and/or wellcare/weightcheck appointments. It might be a good idea to ask about your provider about your lab results soon after the labwork gets done...I didn't do this. I just got a call from my surgeons office. I thought they were going to let me know if I was approved or not. I had a stool sample taken 6 months ago when I began this process. They just told me that they were looking at my chart and they cannot submit anything to empire bcbs for approval because I tested positive for h.pylori antigen. Really?? I got all that lab work done 6 months ago, I would think they would want to start treating h. pylori intestinal infection as soon as possible, not after I finished all 6 months of weight check appointments. It's a two week round of couple types of antibiotics and ppi (prevacid)...it's called PrevPac. After the two weeks of antibiotics, I have to wait one week, then take another stool sample. If the h.pylori is gone, then they can submit for approval to empire bcbs. I'm slightly annoyed bc I wish I got a head start on getting it treated. But I'm glad to take care of it, all times I have had stomach problems..maybe h.pylori had something to do with it? ALSO....even with my insurance the PrevPac was $125...just for antibiotics and prevacid. ok, now i'm just bitching. LOL. I'm just going to keep doing what I am supposed to do....and now that I have to wait at least 5 weeks minimum to get banded there is no reason why I can't get a head start on trying to shed some lbs. to shrink the liver and feel better.

<3 lisa

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Lisa i dont blame you i would be upset as well. I have not had a stool study done. I did have to have some labs done for Carewise when i started my 6 mos but was just blood work. I tried to call my surgeons today to find out anymore things i need to do but they havent returned my call yet. I so want to be sure i have everything in gear for my surgery the last of april. I am so hoping i can get it planned for then.

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I think I read somewhere that h.pylori can be detected in a blood test as well (I could be mistaken). The nurse I talked to today said that if it isn't cleared up it can cause complications after surgery, so they have to get rid of it completely. Good luck!..I hope you get approved and everything goes smoothly!! :) I have no patience, cant wait.

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Shannon28 -

I don't have BCBS, I have UHC but I had a BMI of only 35 with High Blood Pressure and High Cholesterol. My paperwork was submitted on Tuesday of last week and they told me it could take 4 - 6 weeks, just like you. I called on Friday and my insurance told me I'd already been approved! I didn't think I would get approved with that low of a BMI and I certainly didn't think it would be that fast but it was! I saw your post and hadn't even made my own victory post yet so I thought I'd post in here and give you a boost! If you dying to know, you can always call your insurance company occasionally and check on the approval just like I did. Keep your head up and fingers crossed!

Thank you! That gives me a lot of hope! My BMI is pretty high (51.5) but I don't have any major health issues so far. I think I will give them a call tomorrow and see if they know anything yet. Congrats on getting approved, I hope your journey goes along smoothly!

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Hi All...

I just finished the required 6 months of "weight check" appointments and submitted to my surgoens office . My BMI is now 37. I gained 6 lbs during this 6 months period since I haven't been to the gym as much with school and work. I have PCOS, high cholesterol, GERD, hiatal hernia, depression, a mild form of sleep apnea (doesn't require CPAP, instead I wake myself up in my sleep before my airway is obstructed about once an hour, my sleep specialist said this would improve with weight loss). The only thing I take medication for is PCOS. I have Empire BCBS and the nurse coordinator had submitted all my paperwork from the weight check appointments to insurance company either Friday afternoon or on Monday. Every minute of my day is consumed with wanting to know if I will be approved. Since I do not have high blood pressure or diabetes, I have anxiety that I will not be approved, especially since I gained 6 lbs during this period. I'm so eager to have the surgery that I'm afraid I'm setting myself up to be really crushed if I get denied. I feel like it could go either way with the approval. Anyone with a similar situation? Anyone with Empire BCBS?

<3 lisa

I was the same way you are.. Before my surgery was approved I was panicking they would not approve it. I have Horizon BC/BS and had no other medical issues and was approved (I have since found out I have sleep apnea though). You have other medical problems so it shouldn't be a problem for you to get approval. Just wanted to let you know you are not alone with the insurance approval anxiety. Good luck Lisa!

Lisa

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I think I read somewhere that h.pylori can be detected in a blood test as well (I could be mistaken). The nurse I talked to today said that if it isn't cleared up it can cause complications after surgery, so they have to get rid of it completely. Good luck!..I hope you get approved and everything goes smoothly!! smile.png I have no patience, cant wait.

LisaJane, After much thought on this. I have decided i would be broken hearted if i went for my preop only to be told i could not have my surgery related to this. So since i work with PAs and MDs i discussed it with a PA and we have decided since it wouldnt hurt I am going to do the Treatment for it now. That way i should be fine by time I go for my pre-op. Sorta a preventive strike. I may not have it anymore but would much rather be sure.

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I am feeling the same way I just had my last doctors appointment yesterday.. and cant help but stress out about my insurance company approving my surgery.. i went up and down through the whole six months.. would lose one pound.. gain two lose 1 gain two lose 5.. and ended up gaining three back.. I really dont have any health problems either besides being overweight forever.. bmi of 43.. but Im borderlined for diabetes.. but i have done everything.. never missed any appointments.. had a bunch of tests psych eval went to a biatric glass and met with my nutritionist multiple times.. Im sure will be okay just cant wait to have that pressure off my shoulders!! Good Luck =)

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