Do you think that since I have one more month to go on my six month supervised diet before surgery, that my ins will let me go ahead and get the referral for the psych and nutrition appts now?

Nope they did'nt. I have one more week left(of 6 month diet program) and my ins will not approve psych or surg consult until I finish my full 6 months.

Which insurance do you have? I was advised by AIGB to get my nutrional consult in as soon as possible. I am about to start my second month.

I have one month left too.

I already had my psych and nutrition consults though. Neither were covered by insurance anyway. Ouch! $250.00 each.

I better get approved - lol.

I have Pacificare HMO and I hear that it take a very long time to schedule the psych and nutritionist appts. They are just making me wait.:rolleyes

I think I will give a call, so I don't

fall through the cracks

My six months are up and now the Ins wants my doctor to resubmit for referrals to the psych and Diet guru. My doctor tried to submit a few weeks before I graduated from the 6 month diet program, but they are sticklers and will not do anything before I have finished the next hoop.

Basically, they are refusing me to jump through two hoops at the same time :rolleyes

And now my ins is playing a special little game with me called..."we never got a referral request from your PCP"

My response is, "well, I saw her fax it to you three times"

HMO ins response was..."have her try it again" Bub bye:)

This has been holding me back for 2 weeks now..waaaaaaaa....

All this just for one visit with a nutrition consult.

Hi, I have Firstcare here in Texas and my Insurance provider covered my psyc already and just sent in the results back to the bariatric center here, turned what medical records I had, been on the supervised diet since january of 07, lost 12 pounds since the end of June which for me is really good. I got my first Dr. visit on July 3, and on July 5 I meet with the dieticitian and I am just wondering if I have been approved or not by Firstcare because I ahve not heard a word but I am not paying anything to see these people this week. My Dr. is an in plan HMO Doctor, I was sent information and also told over the phone that since he is an in network Dr. and so is the facility etc in the same plan that the only reason I am having to get prior authorization is only due to the hospital say. has anyone ever heard of this before if so let me know. Thanks Sharon...sharrroc@aol.com

I started my supervised diet in June, and I have already been to the surgeon, nutritionist, dietician, exercise specialist, and psych. And I have to wait a year before my insurance will cover me?? In the meantime, I have to keep going back to these people. Yup, my insurance is paying for those visits.

I have Atnea POS and they cover it...very well incase any of you are looking for a great insurance plan.

I started my 4 month process on July 2nd so my doctor/well it's actually the nurse there says that I should be completely done with all that stuff by Oct 2nd. She seems very optimistic that Atnea responds quickly and I should be able to have the surgery in November...any one else have Atnea? Were they fast/slow??

So my question is...if they can get me to lose enough wieght where my BMI no longer meets Insurance requirements, then they don't have to pay -right...I am at a BMI of 41.5 and the requirement is 40 so my ins will pay for the surgery...Tell me if I am thinking right, I don't wanna lose a little wieght because if I do, it could disqualify me - couldn't it?

Thanks for your input ladies and guys!!

Gosh! Are you sure they told you right?! That seems a bit much. I might call some different folks at the insurance company and ask them to confirm that. If that is right that you have to wait a YEAR that's not cool!! So sorry if that's the case.

:help:Hey i have Aetna POS also and I am confused about the # of visits for preapproval,, has anyone worked with AGIB for insurance approval in the DFW area or Lapbandsolutions some lady named Jasmine?

This question came up at my seminar back in March so eone asked well what happens if she lost weight before she got approval would this go against her and the Dr, said no so I think it depends on the insurance company. I was approved before my actual 6 month. I discussed this with my Dr. in january but when I went back in Feb. she asked me if I was still considering it and I said yes and thenthat is when she went to work sort to speak. I have a great Dr. here in Killeen, TX and the Bariatric Staff in waco, TX are a bunch of real nice people. I still ahve to go for my pre op appointment and lab tests and what ever else I might have to have before surgery.

I have Aetna POSII and it has been very slow...I have been denied due to the 6 month Dr. supervised Diet or 3 month multidisciplinary pre surgical program. I have since finished this 3 month program as of May 29th, 2007. The recieved all my appeal paperwork from the surgeon. I am still waiting..............I have already had phsyc eval, upper GI, stress test on heart, EKG, bloodwork, surgeon visit, nutritionist........but still I wait....I have more than enough criterai met, BMI is 52.....lost weight during the 3 months.....33lbs down......but still I wait...........