For those with BCBS... what has been your experience with the 6-month diet? Were you able to get banded SHORTLY after the diet ended? Meaning, did the rest of the process continue along, making you immediately ready for surgery as soon as the diet was "done"? Or did you have to do the diet, then wait another 6 months before surgery (e.g. following up with psych evals, sleep studies, etc.)? I'm getting married at the end of November, and I'm hoping to be banded well before then so I can be on the road to recovery.

Thanks for the insight!

I haven't been banded yet, but I'm in the middle of my fifth month of dieting for BCBS-IL. Here's how mine's been handled and what my surgeon's office said:

- after my fifth nutritionist visit (five months) the nutritionist's office sent preliminary notes to the surgeon's office.

- The surgeon's office called me, and told me to start collecting my other doctor's records (five years of weight loss history, any co-morbidities) in the next month. We also set up a date for my psych eval, required by BCBS.

- after my sixth visit, final notes from the nutrition office will go to the surgeon's office.

- surgeon's office said they should have the psych eval notes within a day or so of the appointment.

- surgeon's office said it generally takes 2-4 weeks for BCBS to hand down approval, and that surgery is generally scheduled within a month of approval.

Hope this helps. Good luck! The six months has gone by more quickly than I could ever imagine...

- jen

I have Humana and it took a total of a year. 6 month diet then 6 months of jumping hoops! I have a co-worker that after her 6 month diet she was banded BOOM! Mine was set up to go like Jen's....but <shrug> either way I am very glad I stuck it out! The band has been a blessing

Good-Luck!

Jen-

Where are you having your surgery done? I plan to go through Fairview Southdale in Edina, MN (I've heard great things about their docs and general care).

Thanks for the heads up, and best wishes on your surgery!

I'm in Chicagoland, so I'm using the Kane Center through Alexian Brothers hospital here -- it's NW of the city.

My sister lives up in Minnesota -- she's in Waconia, which is out near Eden Prairie, ish.

Good luck on your wedding and the whole process!

- jen

I also went through the Kane Center (Dr. Rantis). I already had my six month diet completed before starting the whole process. It still took six more months to go through all of their evaluations (and I didn't even need a sleep study, which would have pushed it back at least another month since the pulmonologist you need to see never has any openings).

Oh, I'm seeing Dr. Rantis too.

How'd you like him through the whole process? I was impressed iwth him at my seminar and at my consult.

Yeah, I was a little annoyed that the psychologist visit will be AFTER my six month weigh in. Oh well.

- jen

He's been great. There have been a couple of times when I only had a follow up appointment with his nurse, Karyn (who is the nicest nurse ever), but if I wasn't feeling well or really needed a fill he'd make time to see me without an appointment. He also asks me what I want whenever I go in for fills instead of just telling me he's giving me X amount.

I too am begining my lab band journey. I see the surgeon on April 9. I have BCBS of IL and have a question concerning the diet and the six month span. When I phoned the insurance company I was told if I had been on a physician supervised diet within the last two years then that would be all I needed. Do you know if this is true?

As long as there were six visits each a month apart, that would satisfy the pre-op diet requirement. My six months was actually a little over two years prior (Jan-June 05 with pre-auth documents sent in July 07) and I was fine. But my BCBS IL plan still made me provide medical records for the past five years documenting my weight and blood pressure at each visit (at least one per year).

Edited April 1, 200818 yr by M Taylor

this has been really helpful info... thank you so much! gives me a good idea of what to prepare for. Hopefully I'll be able to do as much as I can simultaneously.

M Taylor

Thanks so much I see my PCP tomorrow and want to have a list of the info I will need. Congratulations on the 45 pounds lost. Keep up the good work!!!

Have any of you with BCBS (I have Blue Shield Access HMO and am in CA) been approved without 5 years worth of records. Does it have to be the last 5 years?

I have not had insurance and maybe have 1-3 doctors visits during this time. However, since I've had 6 kids (starting in 1981 and ending in 2000) I can get them weight/blood pressure records in 9 month increments from the obs office:blink:

I really hate to think I'm going to have to wait 5 years to begin this process. I believe I'm a great candidate for surgery and my BMI is 42.

Thank You!

Cindy T

I started my BCBS of AZ preop in August 2007. They had 3x a week to the gym, weekly weigh-in at the doctors office, nutritionist visits and I couldn't gain more than 5 lbs over my start weight (ever). I was almost done with the six months in January when BCBS of AZ dropped all the prereqs! Anyway I was able to get approval about 10 days after submission after that.

I had to supply one progress note from my doctor for each of the last five years showing my weight (to show a chronic problem) and other notes about hypertension, sleep apnea and everything else. Since I was almost done with the six months anyway when they changed it I had all those notes as well which probably helped me get approved so fast. I was on weight watchers (sort of) during the six month period and my weight seemed to stay between 355-365 the entire time.

ErikMesa :huh2:

Please ignore my post above. It was not intention to post that in this thread. Just one more example of how the mind begins to go at 45:wink_smile:

Cindy T

I too am begining my lab band journey. I see the surgeon on April 9. I have BCBS of IL and have a question concerning the diet and the six month span. When I phoned the insurance company I was told if I had been on a physician supervised diet within the last two years then that would be all I needed. Do you know if this is true?

Don't trust them!!

I too was told, in very general terms, that I "only" needed to be on a 6 month diet - talk to my nurse or doctor each month with weight taken and fulfill the other requirements (5 year history, pysch eval., nutritionist appt. etc..) and I would be all set with getting the surgery approved. WRONG!! I submitted everything, including a 6 month diet w/doctor, all tests required by insurance and surgeon, even a diet/excersize log for 10 months - they denied me saying my doctor wasn't specific enough in her notes about the diet program I was on and they needed more than weight and blood pressure for five years - they needed a doctors notation stating I was obese for five years!?! The weights and rising blood pressure stated at every physical, every year wasn't good enough??? The 10 month supervised diet wasn't explained fully enough??? My doctor was MAD - she called and wrote a letter stating everything again but it didn't matter.

I thought I was dotting my I's and crossing my T's. If I can tell you anything at all - Get specifics from the insurance company, show your doctor and have them be very specific and long winded about your diet and excersize plan.

No, I will not give up. I've paid my dues with BCBS IL for 14 years and have never used the insurance beyond the basic check-ups, allergy issues and colds. I have apealed and I will win eventually!