Hello, I'm about 2 months pre op and wondering is the anyone else on here that's in my city that's about to change their lives ...

So excited for you! That's great! And I will look into that evergreen hospital thank you! I've been getting some negative feedback from a couple friends today so I'm kinda down. I made the decision and I'm going to do this but it's so hard to hear "just really work out and eat right" and you're just gonna gain it back. I think I'm just not goingt to tell anyone anything from now on. Thank yiu for letting me vent!

Just remember you are doing this for your health, not for what anyone else may think

So excited for you! That's great! And I will look into that evergreen hospital thank you! I've been getting some negative feedback from a couple friends today so I'm kinda down. I made the decision and I'm going to do this but it's so hard to hear "just really work out and eat right" and you're just gonna gain it back. I think I'm just not goingt to tell anyone anything from now on. Thank yiu for letting me vent!

You've made a decision that you feel is right for you and your health. You will have people that will have positive and negative comments, you are doing this for you and no one else matters.

I finally got my referral, but the bariatric coordinator tells me that I can't start the process unless I've been with my pcp for at least a year? So I contacted my insurance BCBS of Illinois H M O...and they told me, it doesn't matter the time frame to receive a referral.

My guess is that, the surgical center has their own requirements... one being that you have to be with your pcp for at least 1 year. Well I have the referral and at least I know that my pcp is weight loss surgery friendly.

I'm going to talk to the coordinator again, because she also said that because I have H M O, they require that too... which is not true.

What do you think guys??? Do you think I should just find a center that will accept the referral or do they all require you to be with your pcp for a year?

I finally got my referral' date=' but the bariatric coordinator tells me that I can't start the process unless I've been with my pcp for at least a year? So I contacted my insurance BCBS of Illinois H M O...and they told me, it doesn't matter the time frame to receive a referral.

My guess is that, the surgical center has their own requirements... one being that you have to be with your pcp for at least 1 year. Well I have the referral and at least I know that my pcp is weight loss surgery friendly.

I'm going to talk to the coordinator again, because she also said that because I have H M O, they require that too... which is not true.

What do you think guys??? Do you think I should just find a center that will accept the referral or do they all require you to be with your pcp for a year?[/quote']

I'm not sure because I've had the same pcp for 13 years. But when I was told that my pcp had to sign a referral, no one stated that I needed to be a patient for a certain amount of time.

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I finally got my referral, but the bariatric coordinator tells me that I can't start the process unless I've been with my pcp for at least a year? So I contacted my insurance BCBS of Illinois H M O...and they told me, it doesn't matter the time frame to receive a referral.

My guess is that, the surgical center has their own requirements... one being that you have to be with your pcp for at least 1 year. Well I have the referral and at least I know that my pcp is weight loss surgery friendly.

I'm going to talk to the coordinator again, because she also said that because I have H M O, they require that too... which is not true.

What do you think guys??? Do you think I should just find a center that will accept the referral or do they all require you to be with your pcp for a year?

My center required that I see a pcp and cardiologist from their group even though I had my own. My insurance BCBS PPO through the city of chicago only required that I had 6 months of visits with a pcp, and, 1 visit with a cardiologist, a psychaitrisit, a pulminologist, and a personal trainer, all of the above for the express purpose of discussing weight loss. So even if I had all these doctors and my center accepted them, I still had to have the required visits and couldn't discuss other health concerns.

Right, I've never heard of waiting a year before you can get a referral for bariatric treatment. She tell me my insurance requires it, no... just say your surgery center requires it. But I got the referral anyways, just in case.

Since 2004, there has always been a problem... either I didn't have insurance or I had insurance but it didn't cover weight loss surgery.

Right' date=' I've never heard of waiting a year before you can get a referral for bariatric treatment. She tell me my insurance requires it, no... just say your surgery center requires it. But I got the referral anyways, just in case.

Since 2004, there has always been a problem... either I didn't have insurance or I had insurance but it didn't cover weight loss surgery.[/quote']

Well keep working on it... Don't give up... You know there are a bunch of hoops and hurdles you have to go through before you get an approval. Stay positive & focused on your goal .

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I finally got my referral' date=' but the bariatric coordinator tells me that I can't start the process unless I've been with my pcp for at least a year? So I contacted my insurance BCBS of Illinois H M O...and they told me, it doesn't matter the time frame to receive a referral.

My guess is that, the surgical center has their own requirements... one being that you have to be with your pcp for at least 1 year. Well I have the referral and at least I know that my pcp is weight loss surgery friendly.

I'm going to talk to the coordinator again, because she also said that because I have H M O, they require that too... which is not true.

What do you think guys??? Do you think I should just find a center that will accept the referral or do they all require you to be with your pcp for a year?[/quote']

I have the same insurance and have only been with my pcp since February. That being said, there are huge differences between requirements. It took a couple talks with my pcp for them to update their paperwork because they swore I needed a 6 month supervised diet. It took me calling back and forth, getting names, and having things faxed over for them to see they were wrong. Different centers have different requirements too. The first place I looked into was close to my house but needed 12 months of supervised diet. It ended up not being covered there anyway. Keep calling! I think it really helped me get my point across. Call your site and ask for their specific requirements because those can be different than bcbs.

I have the same insurance and have only been with my pcp since February. That being said, there are huge differences between requirements. It took a couple talks with my pcp for them to update their paperwork because they swore I needed a 6 month supervised diet. It took me calling back and forth, getting names, and having things faxed over for them to see they were wrong. Different centers have different requirements too. The first place I looked into was close to my house but needed 12 months of supervised diet. It ended up not being covered there anyway. Keep calling! I think it really helped me get my point across. Call your site and ask for their specific requirements because those can be different than bcbs.

Maybe I shouldn't have been so honest about how long I've been seeing my PCP. But I've contacted her, to find out if they will still see me after I've gotten the referral. If not, I'll go to a different facility same surgeon, different bariatric coordinator.

Thank you

You should definitely find out what their exact requirements are. I have Aetna and Aetna required at least two years of my weight being documented. I had switched PCPs (my previous PCP had died and no one could locate my records) I had only been with the new one for less than a year. Luckily I was able to get a copy of a visit from my gyne. It didn't matter that it wasn't my PCP, but as long as I had some type of medical documentation regarding my weight.

So, I called the Bariatric coordinator on my lunch break and was completely shocked how cheerful she was too me, opposed to our last conversation on Friday ( she just totally blew me off with, you can't start the process until after a year... Goodbye).

So she cleared everything up, which I still think is a load!

So, the plan is to attend my consult on the Sept 9th and have all the pre-op testing and paperwork completed, but she doesn't plan on submitting my paperwork to the insurance company until after I've been with my PCP for 1 year. WHICH IS ODD, because medical test results change everyday...hmmmmmmmmmmmmmm

Not really worrying about the approval, because I don't have any requirements... all they need is a letter from my PCP saying the procedure is "medically necessary" attached to the packet and it will be covered.

Not sure how all this is going to pan out... but hey, I'm planning on stretching it out as long as I can... I'll have a one test done a month if I have too.

I need to build up my vacation time anyways... Looks like "2014" will be my sleeve year! LOOKING FORWARD TO IT

So' date=' I called the Bariatric coordinator on my lunch break and was completely shocked how cheerful she was too me, opposed to our last conversation on Friday ( she just totally blew me off with, you can't start the process until after a year... Goodbye).

So she cleared everything up, which I still think is a load!

So, the plan is to attend my consult on the Sept 9th and have all the pre-op testing and paperwork completed, but she doesn't plan on submitting my paperwork to the insurance company until after I've been with my PCP for 1 year. WHICH IS ODD, because medical test results change everyday...hmmmmmmmmmmmmmm

Not really worrying about the approval, because I don't have any requirements... all they need is a letter from my PCP saying the procedure is "medically necessary" attached to the packet and it will be covered.

Not sure how all this is going to pan out... but hey, I'm planning on stretching it out as long as I can... I'll have a one test done a month if I have too.

I need to build up my vacation time anyways... Looks like "2014" will be my sleeve year! LOOKING FORWARD TO IT[/quote']

Sorry its going this way for you. There is a reason for everything..you have the right attitude! Dont give up

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Sorry its going this way for you. There is a reason for everything..you have the right attitude! Dont give up

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There is nothing to be sorry about, I'm in a position that... for once, I can finally have this surgery, after being told the surgery isn't covered or a list of requirements that I couldn't meet. I can wait the 12 months, that'll give me time to right the wrongs, stop smoking, practice portion control, research nutrition/ understanding it 100%, and get mentally prepared.

I'm grateful that I don't have any other requirements that could delay this.

There is nothing to be sorry about' date=' I'm in a position that... for once, I can finally have this surgery, after being told the surgery isn't covered or a list of requirements that I couldn't meet. I can wait the 12 months, that'll give me time to right the wrongs, stop smoking, practice portion control, research nutrition/ understanding it 100%, and get mentally prepared.

I'm grateful that I don't have any other requirements that could delay this.[/quote']

What a lovely attitude

I have my last pre op class in the morning... Surgery next Tuesday...

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