Approval Requirements?

[goirish78 100]

In reading some of the posts, it seems as though the approval requirements vary widely depending upon your surgeon and insurance carrier. I'm curious as to what the requirements have been for the folks in our group of July sleevers?

I have Highmark Blue Cross/Blue Shield DE PPO insurance, and my surgeon operates out of Christiana Care Hospital. Mine seems to have been one of the lengthier pre-op programs, and had the following requirements. The thing that is so amazing to me is that I was required to do all of this, but I don't have any other conditions (i.e. I'm just fat); I can't imagine how many more appointments my classmates with other conditions must have had to go to.

- informational seminar

- initial consultation with surgeon

- initial appointment with cardiologist

- initial appointment with pulmonologist

- 1st sleep study

- Echocardiogram

- 2nd sleep study

- Pulmonology follow-up & CPAP prescription, 1st clearance

- Cardiology follow-up, Echo reading, 1st clearance

- CPAP fitting appointment

- 6 months of supervised weight management program

- Endoscopy

- 3 weeks of life skills pre-op classes

- 1st set of labwork

- Health and weight history appointment with nurse practitioner

- Psychology clearance

- Pulmonology follow-up and 2nd clearance

- Cardiology follow-up and 2nd clearance

- 2nd set of labwork

- Final medical clearance appointment with endocrinologist

- Insurance approval

- Pre-op appointment with surgeon

Yet to be completed:

- 2 weeks of pre-op Optifast diet

- 3rd and final set of labwork

[NoneYa 380]

Wow! I had 1 NUT consult, 1 psyc eval with a therapist, a sleep study (req by the anes. Dr, not the ins. Submit on Thursday, approved on Tuesday. I will see the surgeon this week and get the date set then.

[Vixynne 695]

The hoops I jumped through were pretty basic ones--I have Harvard Pilgrim Health Care medical insurance (Massachusetts). You can read all about 'em in my signature.

My beginning info seminar was in April, and my surgery date is July 1st!

[goirish78 100]

Thanks for the responses. Sheesh! I guess I had even more hoops than I thought. I'm all for being thorough in the interests of safety and health, but I'm feeling a little like there were some extra things tacked on there. Congrats on your July 1 date!! So exciting that July will be here before we know it

[Truckerchic_M 92]

I have Geisinger Health, they have a bit of a list also. It is a 6 month program, I got to skip couple things like sleep study and I already had gallbladder out years ago. I only have my psych left to do.

I hated having to wait but im kinda glad because its giving me time to work into the new lifestyle im going to have and I have lost 25 lbs...just cant wait to get it done!

[Christine O. 7]

My surgeon's requirements were stricter than my insurance. I had my info seminar in November. It took me a whole to take the next step, so it wasn't until late January that I had my surgeon's consult. Then I had the psychologist and nutritionist, 2 nutrition classes (2.5 hours each), sleep study (no apnea), cardiac stress test, upper endoscopy, complete labs early in the process and I'll be redoing them for pre-op this week, lose 20 lbs, meet with anesthesia and surgeon again this week, and then 1 week of liquids.< /p>