Hi Everyone,

I just wanted to share with you all that I've finally got a surgery date of July 24. After a year of waiting lists,testing and jumping through hoops, It's finally my turn. The only thing that makes me worry now is that my insurance company (BCBS of Ma) has new guidelines stating that if your BMI is under 40 with 2 co-morbid diseases, they do NOT have to cover you unless the diseases are to the very extreme, meaning you could die if you didn't lose weight right away. BUT my Dr. is pretty sure I'm okay. My BMI is 39.8 with 2 co-morbid diseases but, I do have many other medical issues that would benefit me if I lost weight, so the Dr. thinks this is what will get me through.

Now don't get me wrong.. I know that the insurance company doesn't have to cover anyone. I'm just stating that they've changed the severity of the co-morbid disease.

Anyway, wish me luck. I'm told that the ins. comp. will inform me either way. I'm not sure how long it will take, but i'll be waiting by the phone. How long did it take for any of you to hear from them?

Same here. I was approved two days after the paperwork was submitted.

YOU GUYS ARE SO LUCKY!!!!

wantlapband,

I also wanted to tell you that my paperwork was put in to BCBS on 6/14/06 and wasn't even assigned until 6/29/06. I called them every day to see if it was recieved and assigned. Once it was, I was told they have up to 30 days to approve it. Since my surgery would before then, they said it would take about 15 days. I was told that people who have earlier dates, that needed approval for their specific surgery, would obviously be approved first.

Best of luck to you, let me know if there is any info. that you have that I'm missing. Thanks, in advance.

My PCP said she will write the letters necessary for the surgery to send into the insurance company. She'll write whatever the surgeon wants her to write.

What does the surgeon require from paperwork. Does he want you whole medical file? Mine is so THICK at Brigham & Womens, he is at B&W. I know they can look stuff up.

I have an appt with my psych doctor on the 17th anyways for a med checkup, at that time, I am going to ask him for the weight loss stuff he has to do on me.

I have met with so many nutri in the past, do I have to meet with them again? Its such a waste of time, at least to me.

I'm a lightweight at 205, 35.3 but I think I still deserve to have surgery and finally get a chance at being happy once again and being able to do things with my family again. :grouphug: I'm so sad and scared about my appt tomorrow with the surgeon.

hi time to love me,

I am going to Brigham and Womens. I have the appt tomorrow. I see my cardiologist today down there, so I will talk to him more about it and find out what he will write with the doctor, he only wanted me to see this doctor. He actually told me when I asked him about the surgery 3 months ago (I wanted to have approval from him first, since he knows my body) and he said "this would be a good thing for you".

So, the surgeon should set the date for me tomorrow? Should I ask him too? Do they weigh you with clothes and shoes on? I have always been weighed like that. I'll get weighed today by my doctor, I don't have a scale at home. If I have surgery, you better believe I will one :grouphug:.

What kind of questions do the surgeons ask you?

What kind of information do you ask him besides about the procedure?

Do they send in the paper work right away?

Did you bring any paper work with you to the first visit?

Is there more than once initial visit with the surgeon?

Thanks!!

I will answer your questions in red. :biggrin1:

hi time to love me,

So, the surgeon should set the date for me tomorrow? Should I ask him too? I did not have a choice to when the date was set, I had to go to the nutritionist to get to my Dr. What happens at Lahey is you meet with the nutritionist and when she thinks your ready, she'll send you off to the surgeon. She moniters how well you are eating and losing your required weightloss.

Do they weigh you with clothes and shoes on? I have always been weighed like that. I'll get weighed today by my doctor, I don't have a scale at home. If I have surgery, you better believe I will one :grouphug:. Yes, I was weighed with all my clothes and shoes on.

What kind of questions do the surgeons ask you? I didn't have many questions for him because the program at Lahey has a info. session at your consult and then a few weeks before the surgery you go to another info. session with the surgeon and the PA. Pretty much all the answers were right there for me. I also attend the support group, so I've learn so much from that. (the PA and at times, the Dr's run this). But I asked about post op and recovery, food plans, what's expected for my weightloss, How long it would take for me to heal and many more standard questions.

What kind of information do you ask him besides about the procedure? Read above. I know I didn't answer much for you, Like I said, I got so much info. from the get go, that I didn't really have much to ask.

Do they send in the paper work right away? I went to my appt. with the nutritionist, the next day she met with the Dr and PA and told them I was able to move ahead. Paperwork was sent in the following day and it was recieved by BCBS, but it was not assigned for almost 2 weeks. BUT this is how it goes, according to BCBS NE. They have 30 days to approve or deny you. In my case, my surgery will be before that so I will be approved within 15 days from the day they assigned my paperwork. I had to call several times because my paperwork was not in the system, but once it was.. I got direct info.. They told me today, that i have 2 appts. coming up and most of the time they would deny the approval if I wasn't going to be approved.. BUT that isn't a 100 percent approval, it's just from what she has experienced in her position. I was also told from Lahey that I was all set and they have heard it's a green light. I was confused by this, because I thought I'd find out right after Lahey did. The customer rep. stated that usually the cooridinater of Lahey and the case manager at BCBS pretty much know more info. than the customer rep. does.

Did you bring any paper work with you to the first visit? Yes, I brought records of my weighloss and failure history and a letter stating why I thought I should be approved. It was a basic letter stating my history of weight problems starting as early as age 13. I also brought my labs and EKG from my last physical.

Is there more than once initial visit with the surgeon? I will have 2 by the time my surgery comes. Every place is different.

Also, For me it was a breeze at my first appt. It was a day long event, but well worth it. I had my exam with the PA, met with the nutritionist, surgeon, had my lapband info. meeting and had my psych. exam. It was a one day event and I loved it. I didn't have to come back for each thing. They make the process so easy for you.

Thanks!!

:bump2: :bump2: BUMPING for Wantalapband! How was your appt. today???? I hope it all went well.

hey time to love me,

I just got home a little while ago..guess what? The surgeon said YES! I have a surgery date of September 20th, but I still have to wait for the insurance approval. He doesn't think there will be a problem. He wrote down heart disease, sleep apnea, high cholosteral, I think high blood pressure...I'm so excited!!! I go back in August to see nutr. and to get an upper GI. I had one a year ago, but he wants me to get another one to make sure I don't have anything else going on because of my GERD.

Did you hear anything? Your date is coming up. Does the waiting seem long to you?

My cardiologist called me and I am going to be a study for a new blood thinner, why not. Its a shot still but its not suppose to sting as much as the Lovenox I take.

After the surgery, they just have to watch me closely because I have to go off my blood thinners 3 days prior to surgery, then they have to administer them right away after surgery.

I'm SOOOO Happy!!!

I the insurance company doesn't let me down.

I'm so glad things went well for you today!!! I'm sure with all the co morbid issues, you should fly through the process in no time! I actually got my approval today!!!! I was so excited. The waiting sucked, the first night I found out that the approval was pending, I didn't sleep at all. It took 5 more days before I got an anwer.

Isn't it the way???? We worry ourselves sick over these things when we really don't need to. Best wishes to you!! I hope it all works out the way you plan it too. I'll be here for you.. waiting to hear any news you have to share.

Hey!!!

I am soo happy for you!!!

You have to tell me everything after you have surgery.

When do you go on your liquid diet?

Hey!!!

I am soo happy for you!!!

You have to tell me everything after you have surgery.

When do you go on your liquid diet?

Hey You, GRR I just wrote a huge post and some way, lost it all!

Anyway, I'm very happy for you too! Now that you have the Dr's approval.. You just have to wait for the golden stamp of approval from the insurance comp.. and we'll be both on our way through this process. I'm happy to have a "buddy" to get through this with.

About the pre-op.. I'm lucky, I don't require to have one! I did, however, have to lose ten pounds before I could get a surgery date or even meet with the surgeon. From what the nutrititionist says, I am the first patient in that program that had such a low weight loss requirement. She said that usually the Dr's Assistant sets weightloss goals of 20 - 50 pounds.. depending on each persons situation and weight. I think that is crazy! I wouldn't need the band if I could drop 50 pounds on my own and keep it off. They give people HMR product to help them out.. It's like a liquid diet drink. OHH the other thing.. I only had to drop ten pounds.. BUT.. I have to keep it off or it's a deal breaker with the Dr..... NO EXCUSES! I was like they'll let ya slide.. and nope they don't. I went to my support group and there were 2 people scheduled the same week, so we expected them to not be at the meeting.. and they were because they didnt' keep the weight off. One person gained 3 pounds.. the other gained quite a bit. So i'm keeping it off and trying to still lose more.

I'm so excited but I'm scared at the same time. I have only told my husband about this surgery. I had a bonfire at my house.. inviting close family and friends.. I planned on telling them that I was to be banded.. WELL thank God I didn't. While chatting, one person brought up that a girl at work had WLS and how she took the easy way out and so on.. ALL NEG. COMMENTS. I was taking back a little because these people were so kind and loving and caring about others. I then decided that It was best for me to zip it and not say anything. It hurt me in a way because I really thought I'd have a strong support group through them. I know if I told them now, they'd try to support me.. But I just can't get passed the fact that I know EXACTLY how they REALLY feel and I'm all set with false support, I want people to be truly happy for me.. not because they feel they need to, because we are childhood friends. They will never understand because NONE of them have EVER been overweight in their entire live, including pregnancy. They all range from sizes 0 - 8. I'm the fatty of the bunch! Must be my personality. LOL Jk.. I know they do love me. Anyway.. I'm also scared because every time I go under, for surgery, I have a problem with urine retention and iratic blood pressure. The urine retention stinks because I can't go pee.. So I need to get a straight cath. every so often through out the day.. so my bladder doesn't burst.. AND the BP issue is scary and weird. It get's really low, along with my heart rate. My BP last time I was under was 114/53 and my pulse was 34. Then while recovering my BP shot up to 200/110 and went up and down and all around for a few days.. along with the pulse being low too. So I was kept in the hospital for 5 days all together. I'll hope it's different this time, but it has been this way always. The Dr. tell me that had he not known my history.. he'd be freaking out in the ER. I dont' know ihow true all this is, because I'm not sure how the anestisia (SP) reacts with BP and pulse. I do know the BP is low and so is the heart rate.. but.. Okay.. I've been ranting like a lunitic, writing all this.... Sorry.. this is just my thoughts of today.

We'll both be okay and I want to keep in touch. We'll get through this all.. just fine! We'll be melting this weight off in no time! GO Sista GO :scared:

Hello,

I met with the surgeon who is actually going to do the procedure on me. He is the director of it all. Is that good that I met with the surgeon? Does that mean he will make sure that I am approved?? He made it seem that way...when he gave the paperwork to his assistant to write up all my appts, he mentioned to her heart disease, sleep apnea, RA, GERD, vascular problems...I hope this goes through.

I'm set up for all my appts, pschy, nutri, upper GI test, anesthia (sp), and then another appt with him.

What are your thoughts?

Hello, I'm happy to hear that you have all the appt. set up, in no time things will just fly by for you. Just because you met the surgeon doesn't mean he'll make sure you're approved. He can say all he wants but if the insurance company says they wont' approve you, then all he can do is help you appeal. In my opinion.. I can not see why the insur. comp. would not except you. You have so many major medical issues going on with you, they'd be crazy not to approve you. BUT.. you never know, some insurances are awesome and cover WLS more freely than others do. it's all depending on your Insurance. Do what I did.. once your paperwork is in to the Insurance company. it needs to be assigned to someone.. it takes a few days for them to do this, usually the closer your surgery date is.. the quicker they make the decision.. anyway, keep calling your insurance company until they have an answer. I called everyday until I got mine. I think you're golden and will have no problem. You have more going on than me and I've been approved. I have BCBS of MASS.

Time to love me...

I can't wait to hear from you when you are feeling better. You will have to tell me all about your surgery...

A question: I am a lightweight BMI, barely 40. I assume they'll weigh me at the surgeon visit this week (my first consult). Is that the weight that gets submitted??? I've been slowly gaining over past few months, but have just touched current BMI of 40.

A question: I am a lightweight BMI, barely 40. I assume they'll weigh me at the surgeon visit this week (my first consult). Is that the weight that gets submitted??? I've been slowly gaining over past few months, but have just touched current BMI of 40.

Hi, I am in the same boat......just hit 40 bmi.

They are gonna weigh you, measure you, take you bmi...take a pic (ugh). I had all that done with the nutritionist though. Apparently they keep these and update the info from time to time.