Hello.. I just had my nutritionist apt today and yesterday the visit with the surgeon. Should see the psych in the next couple of days. But, i'm having some insurance fears, as we found this:

NHP covers bariatric surgery for:

Medical necessity for bariatric surgery is established when all of the following criteria are met:

Individuals who are at least 95% of predicted adult stature who are:

1. BMI greater than or equal to 40 (mine is 43)

3. Documented failure of attempts to sustain weight through less intensive, physician supervised methods, such as diet, exercise, behavior modification programs and pharmaceutical interventions ; (in which we are confused if this means that they r going to require a 6 months with supervised program. or if just my medical records, ww attempts, prior weight loss surgery done in 2007 (called Intragastric Ballon - BIB) which didn't worked.) Would those be enough? They already told to expect my surgery to happen by end of march if they approve me...so im very excited and afraid to not get approved?!!! Anyone???

Hi girl!

I had NHP a few years ago and I changed because many people told that BMC its more easy....now' date=' I want the Lap Band and I was reading in the guidelines of each plan and I saw that NHP requieres 2 years of something that I can't remember now (sorry)...and I always have the impression that NHP is more strictly with approvals. ....maybe I'm WRONG!! Where you live? I would like to know abo ut your process. ..! Good luckkkkkk!!!![/quote']

Oh and I forgot that my BMI is almost 35, and I have Diabetes 2 and pre hypertension...

Hi girl!

I had NHP a few years ago and I changed because many people told that BMC its more easy....now' date=' I want the Lap Band and I was reading in the guidelines of each plan and I saw that NHP requieres 2 years of something that I can't remember now (sorry)...and I always have the impression that NHP is more strictly with approvals. ....maybe I'm WRONG!! Where you live? I would like to know abo ut your process. ..! Good luckkkkkk!!!![/quote']

Idk, that's what my surgeon's office said, that bmc requires the diet, and NhP doesnt.

I live in Framingham.

Idk' date=' that's what my surgeon's office said, that bmc requires the diet, and NhP doesnt.

I live in Framingham.

[/quote']

I'm in Springfield...do you know what other requirements have NHP?

I'm in Springfield...do you know what other requirements have NHP?

Looks like they are almost the same, but NHP doest say anything about a previous attempts of medically supervised diet.. (Which bmc asks)

Nhp askd for all the failed attempts but doesnt say about medically.

Which any other attempts like weight watchers, etc would work. (Thats what the office said)..

Here is the link:

http://www.nhp.org/PDFs/Providers/Clinical_Criteria-Weight_Loss_Surgery.pdf

I'm in Springfield...do you know what other requirements have NHP?

This is for BMC: http://www.bmchp.org/app_assets/bariatric-surgery-effective-march-1-2012_20111223t095539_en_web_73194e4417d9400dbfcbd0188df5b1ef.pdf (note that they do mention about previous 6months of supervised diet)

Great! I feel that all will be ok for you!!! Good luck with your pre op diet! You go girl!

I will call to my surgeon office, maybe they can advise me about the insurance, or which is more easy to approval in my case, remember I'm a low bander 35BMI.

Thanks!!!

Got approved today! Yay!!

I still cant believe, it was so quick!

The whole journey will happen in less then 2 months.. God is good lol

Got approved today! Yay!!

I still cant believe' date=' it was so quick!

The whole journey will happen in less then 2 months.. God is good lol[/quote']

Yay! Congrats. I told you they are fast and it makes it feel so surreal. When is your surgery?

Yay! Congrats. I told you they are fast and it makes it feel so surreal. When is your surgery?

In a week! March 21

Got approved today! Yay!!

I still cant believe' date=' it was so quick!

The whole journey will happen in less then 2 months.. God is good lol[/quote']

OMG!! Im so happy for you!! So fast, how they do? What they ask or what papers you used???? Tell me !!!!! Im really happy for you....♡

OMG!! Im so happy for you!! So fast' date=' how they do? What they ask or what papers you used???? Tell me !!!!! Im really happy for you....â¡[/quote']

I know, right?!

Well, they used a letter of my pcp saying how long i've been trying to loose weight, and that i was a perfect candidate.

And i dont know what the surgeon sent, as they deal with ever everything insurance wise. I havent done anything, just the nutritionist and psych evaluations. They did everything.

I know' date=' right?!

Well, they used a letter of my pcp saying how long i've been trying to loose weight, and that i was a perfect candidate.

And i dont know what the surgeon sent, as they deal with ever everything insurance wise. I havent done anything, just the nutritionist and psych evaluations. They did everything.

[/quote']

Great! Im gonna check your surgeon office....I dont know if is far from here....congrats again! Let us know about your progress and diet!

Great! Im gonna check your surgeon office....I dont know if is far from here....congrats again! Let us know about your progress and diet!

Yes, call them! They are great! Talk to Jayne when you call.

Here is the website: http://www.massweightloss.com/

Even if it is far for you, you can book the apt all in the same day, and you will need to come only 2 times, then for your pre-op apt. its worth! I live almost 1hr away too

Yes' date=' call them! They are great! Talk to Jayne when you call.

Here is the website: http://www.massweightloss.com/

Even if it is far for you, you can book the apt all in the same day, and you will need to come only 2 times, then for your pre-op apt. its worth! I live almost 1hr away too

[/quote']

Thanks, I checked the website and I will call tomorrow. I live 1:30 away..but I dont care is like u said I can book all the apt in the same day.....In your experience, I have to attend the seminar? Its very hars for me at 7pm, and what do you think about my bmi...is 35 with diabetes 2 and prehypertension.... I really need a good surgeon office with experienced people to fight with insurance approval. Another question (sorry) lol, your pcp need to know your surgeon name? I ask because my pcp is part of Baystate Hospital and they have a Bariatric Surgeons, but I dont like it....do you have any problem with your pcp or insurance ffor choose a non local surgeon???? Thanksssssss

Thanks' date=' I checked the website and I will call tomorrow. I live 1:30 away..but I dont care is like u said I can book all the apt in the same day.....In your experience, I have to attend the seminar? Its very hars for me at 7pm, and what do you think about my bmi...is 35 with diabetes 2 and prehypertension.... I really need a good surgeon office with experienced people to fight with insurance approval. Another question (sorry) lol, your pcp need to know your surgeon name? I ask because my pcp is part of Baystate Hospital and they have a Bariatric Surgeons, but I dont like it....do you have any problem with your pcp or insurance ffor choose a non local surgeon???? Thanksssssss[/quote']

First, they did not require the seminar, i didnt go.

Second, ur bmi being less than 40 but with ur co-morbities is probably ok, but u can always wear some ankle weight to add some extra lb hahaha i went wearing my snow boots, jacket, etc lol i weighted 8+lb hahaha

My pcp just wrote the medical necessity letter like for who it may concern, and the referral she sent it in the name of my surgeon, ur pcp will only need one special surgeon's number.

You can tell ur pcp that is a surgeon that u had good references, and u want to do it with him..

I think its going to work!