Hello all! I have lurked here for quite a while - soaking up a wealth of knowledge. My first appointment with my surgeon is today so I thought I would join in the fun. I am 44, have a BMI of 39, high blood pressure, prediabetes, and osteoarthritis. I am super nervous about getting my surgery covered by bcbs. I have 7 years of medical records. One of those years (within the last 3) my BMI dipped below 35. So my physician and I have decided to not include that record in the submission to insurance and supplement with photos. Hopefully my comorbidities and recent diagnosis of polycystic kidney disease will help my case. Ugh! The thought of being denied after all this hard work and hoop jumping... makes me want to cry... and I still have 5 months to go. Yikes! I am hoping for an informative, positive, motivational meeting with my surgeon today. Here's to the start of a life changing journey.

Hello all! I have lurked here for quite a while - soaking up a wealth of knowledge. My first appointment with my surgeon is today so I thought I would join in the fun. I am 44, have a BMI of 39, high blood pressure, prediabetes, and osteoarthritis. I am super nervous about getting my surgery covered by bcbs. I have 7 years of medical records. One of those years (within the last 3) my BMI dipped below 35. So my physician and I have decided to not include that record in the submission to insurance and supplement with photos. Hopefully my comorbidities and recent diagnosis of polycystic kidney disease will help my case. Ugh! The thought of being denied after all this hard work and hoop jumping... makes me want to cry... and I still have 5 months to go. Yikes! I am hoping for an informative, positive, motivational meeting with my surgeon today. Here's to the start of a life changing journey.

Welcome, welcome, welcome happy to have you aboard. A good place to get information, give your story onto a new you and just reach out and vent if need be. We are here to help, read, and some advice if asked. Trying to get approval with your insurance is nerve racking to say the least. But after going through the lapband procedure and then its removal, and a discussion with the doctor's office regarding RNY, I find when you have a good doctor, a good team behind him, they usually know what you need to get approval. I've had two different doctors in two different clinics, two different insurances and haven't had a hiccup. I've not had my RNY yet as my doctor wants my stomach to heal from the removal of the lapband, should be sometime in September, and I have about two more hoops to jump through for the submission. Do want you to know my heart goes out to you about your recent diagnosis of polycystic kidney disease, your WLS will be a breeze compared to this disease. I used to work for a Nephrologist so quite familiar with it. Also have a daughter two years younger than you, who has been a chronic stone thrower since she was 19 and her daughter has inherted this problem also. Unfortunately they don't know what to do as Mayo Clinic cannot figure out why she produces so many kidney stones. Her kidneys always have at least 15 stones if not more in each kidney at any given time. Keeping fingers crossed that you get good news today and everything goes well. Onward to a new you.

Hello all! I have lurked here for quite a while - soaking up a wealth of knowledge. My first appointment with my surgeon is today so I thought I would join in the fun. I am 44' date=' have a BMI of 39, high blood pressure, prediabetes, and osteoarthritis. I am super nervous about getting my surgery covered by bcbs. I have 7 years of medical records. One of those years (within the last 3) my BMI dipped below 35. So my physician and I have decided to not include that record in the submission to insurance and supplement with photos. Hopefully my comorbidities and recent diagnosis of polycystic kidney disease will help my case. Ugh! The thought of being denied after all this hard work and hoop jumping... makes me want to cry... and I still have 5 months to go. Yikes! I am hoping for an informative, positive, motivational meeting with my surgeon today. Here's to the start of a life changing journey.[/quote']

Welcome! As I read the beginning of your post, it sounded exactly like what I could have written, minus the kidney stuff. I have BCBS Alabama and am nervous about submitting, which should be on July 8. This site has been the best tool to us as I have gone through this process. The people Ono here are friendly and there is always somebody who can answer your questions because they've been through it. Glad you're here!

You shouldn't have any problem getting an approval thru bcbs of alabama. I have bcbs of alabama. I called and spoke to a rep and you shouldn't any problem getting approved as long as you meet their criteria and provide medical necessity. I have gotten approval within a week on the five other surgeries I have had.

Thanks y'all. Everything went well Thursday. I am on schedule to have my surgery in December if all goes as planned. I would love to take off work during the holidays so I won't have to use as many vacation days! Time is gonna go so sloooow! Ugh! Thanks for the concern about PKD. I haven't had any symptoms yet. In fact, my mom (who I got it from) never knew she had it. We only surmised this after her death from COPD because of other family members' diagnosis. So I hope to follow in her footsteps and never have any problems! Fingers crossed.

My doctor did recommend the sleeve instead of the bypass. I hadn't seriously considered it until now. His reasoning was that I am "only" 100lbs overweight and I would have less issue with nutritional deficiencies - which is big concern for me especially with PKD. So now I am researching the sleeve. He said he would do either operation I decided on, but when asked for his recommendation, he said the sleeve. And I highly value is opinion. He removed my gallbladder years ago - and I was very impressed by his expertise AND bedside manner.

So the journey continues... : )