Dr. Sanchez- Monterrey Mx

December 10, 2003

Thanks, Vera you've been super helpful. I was stressed out about playing the waiting game. I have a BMI of 41 so I'm not going to even depend on my insurance company to help me here in the states.

I've got enough monkeys on my back and the insurance company is like a gorilla.

Thanks again:

Vera · December 10, 2003

Thanks Barb, My AMI buddy!

Sandy I too had a BMI of 41 and knew the Insurance game would be tough, BUT I have put in a claim as soon as I got back from MX, Blue Cross wanted Doctor op notes, which I provided, then they just rejected my claim. So I'm trying to get some kind of appeal/explanation of future problems that I may incounter if I were to continue to be obese and the family history of obesity... Eric, Ann-Marie husband, says a lady in Minn. got her Insur. to pay 50%, so its worth trying harded to recover some of my expences.

If you think you might put in a claim, make sure you get all your paper work before you leave MX

receipt of amount paid

doc op instructions

your band type and its s/n

Have them e-mail copies as well. Some other patients of Dr. Sanchez have had a hard time geting all the info they need once they've come back into the US. I have got everything that I have requested, not a problem.

Dr Sanchez himself is one of the best lap doctors there is! He is truly wonderfull.

Good luck

sassaay · December 10, 2003

Hi Vera,

I am not sure if you already mentioned this, but I was wondering if you tried to get your insurance to cover Lap-Band prior to going to MX for surgery. I too have a BMI of 41 with no comorbitities. I was referred by my primary care physician to see the surgeon and my first appointment is today. Right now, I plan to try and see if my insurance will cover the procedure and I may even go as far as trying for an appeal if necessary… But, I have done my research and decided the Lap-Band is the option for me and may end up in T.J., MX with Dr. Kuri if I get too frustrated dealing with my insurance company.

Thanks in advance for your feedback.

Vera · December 10, 2003

Anne

Back in June, I did call my insurance co. to see if they covered lap and was told with "medical review". After reading and speaking to others regaurding the approval process, I realized my chances were slim, I'd be fighting all the way and could take (I'v heard of 6 mos., a year).. to get aproved. I didn't want to wait, I didn't want to get fatter. I was missarable and knew I wanted a band.

I didn't know of any extremly qualified doctors in my area either.

So I made more calls to patients of Dr. Sanchez and decided to go to MX....I'm so glad I did, I feel better each day.

Lately I'v heard of people being approved in just a few weeks, but not those with my ins co.

A new doctor opened his practice near me the day I had my sugery. I use him for fills, he says alot of people want the band but there not getting the ins approvals.

So with time I'm seeing more advances in the Lap Band world. I hope the Insurance companys will come up the the bat.

sassaay · December 12, 2003

Vera,

Thanks for the reply. I too am concerned about how long it might take especially if I am first denied and must go through the approval process.

My first appointment with the surgeon went very well and she said pretty much the same as you… A lot of insurance companies still won’t approve the Lap-Band. She is even in the process of helping one patient with an appear to Blue Cross as they have told this patient that they won’t cover Lap-Band because it is still an experimental device.

This surgeon is of the opinion that Lap-Band is the best option younger people with BMI’s over 40 and no co-morbidities. She is willing to help me in any way she can, so I am feeling very lucky. Now, I need to get an EKG and Chest X-ray and wait for word from the insurance company.

Thanks again for the info.

All the best,