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helplessly waiting

done all what was asked for as far as BLUECROSS/BLUESHIELD ask for.

my lap band coordinator is suppose to be sending the paperwork to them....

i am 277lbs now. cry most of the time. hope i can get this done. does

anybody know DR. RICHARD ANDERSON thats with dallas.... TO EACH OF

YOU THAT HAS HAD THIS SURGERY..... GOD BLESS YOU AND KEEP YOU.

YOUR VERY LUCKY. KEEP THE WEIGHT OFF. maybe i will get approved for this.

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  • Author
Dell,

What's the latest? I was thinking of you and wondering how it is going? You know, you can always transfer to another doctor if you don't think they are "going to bat for you". Dr Benavides in Richardson has tried very hard for me. Just a thought......

TAMBONSJO, THANKS ALOT FOR THE REPLY. HAVEN'T HEARD ANYTHING

YET.. MAYBE SOON. IF I DON'T GET IN SOON. I'LL TRY AND GET ANOTHER

REFERRAL FROM MY DOCTOR TO SEE ANOTHER ONE. HOPE YOU ARE OK TOO

HELPS HEARING FROM PEOPLE LIKE YOU.. HAVE A GREAT DAY OR NIGHT

TRUELLY YOURS DELL

Hey Dell- I too am in the "waiting game" with insurance. My paperwork was submitted last (need to call to confirm that) with Dr. Benavides office in Richardson. I have Horizon BCBS and understand that they do cover the band. We'll see.

I had to do all of the following done to try to get approved:

psych test

blood work

sleep test - I've got sleep apnea, didn't know that before!

5 years of medical records

weight loss attempt history

stress test

nutrition/dietician appointment

Took about 6 weeks to get all THAT accomplished, now I'm waiting on them. Cross your fingers!

  • Author

Makena,

Got your message today. Sounds like me and you been through the same

things. I know how you feel. I just hope we get approved!!! Sometimes I wonder

if it is all worth it??? We are just putting more money into this having the test done.

YOU GO ON AND HAVE IT HONEY!!!! I don't blame you a bit. I'm going to call Monday

and see if they even have summited my paperwork. Wonder about that too. Let me

know about you .. HAVE A GREAT DAY.

LOVE, DELL

I am waiting too. My Doctor is Dr. Veninga. He said I could wait until I hear from the insurance company before I do the psych. thing and nutritionist. I didn't want to put out that money if they weren't going to pay.

  • Author

okiejudy, sometimes you have to do things to see how they play out. The more

information you have , maybe you will be ok'ed for the surgery. I've done it all

and hope to be ok'ed for the surgery. if I'm not I will appeal and do everything

to get it done. okiejudy, I wish you the best of luck. hope to hear from

you soon. love, dell

Hi Dell, I am also working with Dr. Maese and Dr Cribbons as the surgeon to get mine approved. I've had the stress test, all the blood work, the sleep study (that was interesting) and the psyche eval. So far so good, now I am just waiting to get approved....

Which surgeon are you using? Dr. Maese's office has ben very helpful for me and I just LOVE him!!

Good luck and just keep bugging your insurane and your employer to cover this, In the long run they will save tons of $$ by not paying for us when we get diabetes!!

  • Author

Bubblestina,

Got your reply to my post, glad I'm not the only person that has went to Dr.Maese. He is a very caring person. Mine is going through Dr. Richard S. Anderson of Dallas. Wasn't the sleep test fun!!!! I hated that... My insurance is Blue Cross/Blue

shield of Texas (HEALTH SELECT) through the Mexia State School where I work. I hope you get approved. I wish that we could get some type of petition going against these Insurance people to make them pay for this type of surgery. But I don't think that will work. In the long run they would come out better. Maybe it will work out in the long run. Hope to hear from you soon/ Thanks for the reply. Have a nice day or night. Love, dell

Dell,

Friday was the best day of the year for me --so far---

I rec'd my approval letter from United Health care!! I am SOOOO excited!! I called my sister crying (she called me a sap of course and then started crying also) I faxed the letter to my surgeons office because they had not gotten their copy yet,a nd Monday I am supposed to call and schedule the surg. I could be banded by this time next month!!

It only took 12 days from the time Dr. Cribbons office submitted the paperwork untill United Healthcare sent the approval letter.

Have you heard anything yet?? Do you know what our next step is after we get approved? When do I start the liquid diet???

So many questions!!

Keep me informed of your status...I'm keeping my fingers crossed for you. Maybe I'll see you ar Dr. M's office one day. :)

OK Guys... I got my surg date all set up..

May 6th!!! I can hardly believe this is happening so fast!!! Well actually not that fast, I've been trying for almost 2 years to get approved. But now that I have new insurance it is happening fast.

I am SOOO excited!!

  • Author

Bubblesstina,

Happy you getting the surgery. Enjoy the ride. I'll be thinking of you

on that day. Let me know how you come out. Until then I wish you joy peace and

happiness. love, dell

Hey Dell. Don't give up EVER!!!!!!!!!!! I have fought this fight for three years and I am scheduled for Surgery April 19th. I am so nervous now. I had BCBS Rochester for the last three years and they would not even consider covering the band. At first I thought it was the doctors I was seeing that were simply imcompetent to get the procedure approved. And to be quite honest the first three doctors I saw here in Dallas each washed their hands of me when the insurance gave their denial each time. Precisely why I saw three doctors to begin with. It was as like I was important to the docs until they learned getting the procedure approved was going to be difficult, then I was pushed aside like a piece of trash. Well this year my company switched to BCBS Empire. So here I go again. This time I decided I wasn't going to let the doctors and their Lap Band agencies control my destiny, nor the insurance company. So I got on the phone to the insurance company and grilled them about the lapband procedure and why they wouldn't cover it. I was literally hostile until I heard this faint voice on the other line tell me that they did cover it. After I woke up from fainting the insurance company themselves not only found me a doctor to do the procedure but they also found me a psychologist for the eval. Can you believe it. I am out about 150.00 in co-pays getting this thing going. Now I am scheduled to have the procedure and I am scared to death about losing my relationship with food and am I doing the right thing. But I fought to hard to turn back. I obviously wanted it bad enough to fight for it. Another thing you can do is get your human resource department involved. Sometimes they can run interference for you and get things approved. They are the ones who hire the insurance companies anyway. Well thanks for letting me rant for whatever it was worth. I guess I was just trying to say DO NOT GIVE UP NO MATTER HOW MANY TIMES THEY SAY NO!!!!!!!!!!!!

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