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New to this all...what can I expect?

I live in west Michigan and will be meeting with my surgeon on Thursday for my first consult. I went to a seminar for his services last month and I am just curious going forward what can I expect? How long from first appt till they submit for pre-approval? My bmi is 43, I'm 38, double covered blue care network and priority health with $2700 set aside in flex spending for surgery. I think I've covered all my bases on my own but now the real work on their ends start. I need to write my "why" letter, and ideas? I'd love some input as I think I over killed mine.

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The first appointment to pre approval time frame depends on your insurance and the "hoops" they want you to jump through. My time frame is 7 months. First month was the seminar, Followed by 6 months of a supervised diet, monthly nutrition classes, visits with a nutritionist, psych eval, tests, exercise physiologist appointments, food logs prior to them submitting for pre approval. It's a lot but I'm learning so much.

For your letter..(mine would be long too) focus on your health and how losing the weight would change your daily life. How you are committed to change your lifestyle and things you have already changed in the process.

Good luck :)

  • 2 weeks later...

Mine is almost the same as above. Guess it depends on the program that you are in. But mine required 6 months nutrition classes. Plus psych evaluation along with pulmonary and cardiologist visits. EGD test. Just keep jumping through the hoops. When I first started I thought this would take forever. But now I'm over half way done and looking forward to a December surgery date. It will go fast....trust me!

My first appointment was on 5/22. My surgery is on 9/28. I scheduled everything as soon as i could to make sure I got this done sooner than later.

My insurance required 40 bmi or 35 with comorbidities and following the surgeons program.

The program consisted of the following:

Lose 10 pounts or 10% of weight if over 55 BMI

2 surgeon appointments

3 nutritionist appointments

2 psyche appointments

sleep study

Upper GI and Bloodwork

Cardiologist appointment

Letter of OK from Primary care doctor

Welcome! I'm also from west Michigan. I know Priority Health requires 6 months of supervised visits (that's what I have, and the representative I spoke with said it should be the same across the board, but who knows). I'm not sure if BCN will have different requirements.

My surgeon's office didn't submit for approval until the 6 month requirements were completed. I think every office handles that a bit differently.

Best of luck to you going forward!

Edited by WingFan55

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