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Surgery soon - approval time

kikikt

By kikikt, in PRE-Operation Weight Loss Surgery Q&A

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kikikt    0

kikikt
Posted

Hello! I am coming up on the submission of my paperwork to insurance (BCBS) - so in essence I've jumped through every hoop they've thrown at me, three month dietary counseling, psych clearance, pulmonary and cardio clearance, EGD, the whole nine - the only thing left for me to do is go to the informational class about surgery, pre- and post-op stuff, and then they will submit the same day, Sept. 24. I've been looking on the forums to try to get an answer to how long approval can take when I came across a young lady who said her approval took six months because she has little to no health problems and she is young. I have been worried about this - my BMI just barely clears the 40 point mark, I have no co-morbid conditions and I am (relatively) young at 36. Other than that, most people with BCBS said their approvals took, on average, about a week. Did anyone have the same situation as me going in and if so, how long did your approval take? I have been concerned that they will deny my claim because I feel they will think that I should be able to do it on my own since I barely meet the requirements and I'm not sick.

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Dee_RNY    43

Dee_RNY
Posted

I have bcbs. Submitted yesterday. Will keep you posted. I haven't had to jump thru any hoops yet. Lol

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jasminebsn3    119

jasminebsn3
Posted

I have bcbs federal. I'm 25 with a bmi of 43 and was approved in one week. I was worried also because I have no co-morbities and am fairly healthy but they approved me. I just scheduled my surgery and am excited/nervous. Good Luck and keep us posted!!!

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sandralck1994    3

sandralck1994
Posted

I have bcbs I am 39 with a bmi of 49 and 5' 1" with no major health issues they made me do 6 months supervised weightloss I did not lose much at all I was up and down and insurance approval took less than a week.

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ready2B    263

ready2B
Posted

I have Anthem BCBS and it only took a day for my approval once they got all the right paperwork submitted to them. I'm older (mid 50s) and have a couple of comorbidities, but I don't think that mattered as much as them having all the info correct and that I met all their requirements before things were submitted.

If your doctor submitted documentation that you have tried traditional dieting programs and were not successful in keeping the weight off, then your age really shouldn't matter.

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Dee_RNY    43

Dee_RNY
Posted

I got approved in 1 week. Doc didn't submit til 25 Sept. Bcbs federal standard....now I'm waiting for date but according to ins company it wont be til Dec 3rd. That's my auth effective date. :(

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UrCaliGirl    28

UrCaliGirl
Posted

I have Anthem BCBS and it only took a day for my approval once they got all the right paperwork submitted to them. I'm older (mid 50s) and have a couple of comorbidities, but I don't think that mattered as much as them having all the info correct and that I met all their requirements before things were submitted.

If your doctor submitted documentation that you have tried traditional dieting programs and were not successful in keeping the weight off, then your age really shouldn't matter.

Did they ask you for 8 years of your past weight?

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ready2B    263

ready2B
Posted

Did they ask you for 8 years of your past weight?

They didn't ask me my past weight at all. My PCP just had to put in a letter that I had tried other weight loss programs and was not able to maintain a healthy weight. My surgeon's practice gave him a sample letter as a guide and he used it almost exactly, just changing my name and a couple of minor details. Guess they have that part down to a science. :-) I do think it a lot of it is about the wording and knowing what specific wording your particular insurance company is looking for to meet their requirements.

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jasminebsn3    119

jasminebsn3
Posted

Finally my last report was sent into my Doctor. Now approval time! Nervous, scared and excited all at the same time :)

GOOD LUCK!

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Jen W    2

Jen W
Posted

My doctors help me get approved within two weeks. So far no problems. Meet with h I m again in Nov to set surgery date.

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

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