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Will Bcbs Approve My Lap Band, If My Pcp Is Against It.



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Im new to this site, I just started my testing process on June 13,2012 and so far I have completed the UPPER GI, Psych Eval, sleep Study ( got the results today and Yes I have Sleep Apnea). I have 2 Dietary consults left. My question is I have the Diagnosis of Hypertension, Sleep Apnea, knee pain, early signs of insulin resistance and a BMI of 42. Can my PCP slow down the process,shes somewhat against the surgery , but keeps stating that I need to lose weight and that my symptoms would decrease.

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That all depends on your surgeon and insurance. For instance my surgeon requires a letter of clearance from your pcp stating that you are healthy enough & cleared for surgery. My insurance doesn't care what my pcp says but some insurances require a referral or for your pcp to be on board.

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My insurance didn't require any information from my PCP and my surgeon handles his own pre-operative clearance (after getting cardiac, pulmonology and psych clearance). So hopefully that won't hold you up!! If I may ask, why is your PCP against you having this surgery?

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Im new to this site' date=' I just started my testing process on June 13,2012 and so far I have completed the UPPER GI, Psych Eval, sleep Study ( got the results today and Yes I have sleep Apnea). I have 2 Dietary consults left. My question is I have the Diagnosis of Hypertension, Sleep Apnea, knee pain, early signs of insulin resistance and a BMI of 42. Can my PCP slow down the process,shes somewhat against the surgery , but keeps stating that I need to lose weight and that my symptoms would decrease.[/quote']

My OBGYN doctor wrote my letter. Did not have to do sleep study, EDG and only dietary class. My pcp does not even know I am having surgery. So it depends on your surgeon. My employer also made a deal with the insurance company to cover 75 percent. I work at a hospital do it it all part a wellness incentive package for employees who want to have it done.

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Thanks everyone for the feedback, My surgeon gave me a letter of recommendation to give to my PCP to complete,so I have an appointment this month with her. To JessiG1983, My PcP states that she has not heard a lot of success about the Lapband and I would probably loose only 5 pounds a month. She doesnt understand because she maybe weighs 120 pounds. I have been struggling with this weight for about 8 years and she knows that Its really affecting my health in negative ways. So I will see what she says, I will keep you guys posted. Thanks again everyone, wish me luck.

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I have BCBS and a letter from PCP was required. Maybe you surgeons letter will help.

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If you have a *** it's more managed. Do you need to get your complete summary of benefits and read the bariatrics portion or obesity portion or call you insurance and ask hours that department and they can tell you.

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