I was wondering if anybody had experience with the 6 month Dr. supervised diet required prior to approval of the lap band. The wording in my plan states that you must have been on a Dr. supervised weight loss plan for at least 6 months in the last 2 years. So.....starting in April of 2007 I started seeing a doctor for about 5 months. I then stopped for 3 months, started again for another 4 months and then saw him off/on over the last year. I saw him a total of 16 times in a 20 month period but never for 6 months straight?!?!?! I've read a lot of the posts and looks like it just kind of depends on the provider but I submitted my documents three days ago and am starting to get a little ansty.....

Thanks for all the help.

I have bcbs-IL insurance and am just now looking into lap band my BMI is 42 I have and appt with Diatician and phycyotrist in a couple weeks a referal letter from my Dr and all my paper work filled out and am starting the 6 month supervised Dr visits. Even with all this they can deny you? Im thinking of having the surg done in Galesburg Il and they seem to think Im a candidate. The health reason is I have severe peripheral neuropathy in my legs and losing weight would help take pressure off the nerves. I dont understand I thought bcbs was good insurance. Has anyone had surg in Peoria or Galesburg? please let me know your experiece.

DEANNKUSKE,

I originally started this thread due to all of the horror stories I had heard about BCBS-IL both on this website and from my surgeon. But.....I was approved (within two weeks of submitting) and am scheduled to have the surgery on the 5th. I think as long as you have your ducks in a row you will be fine. If you take the time to read through the posts on here you should find some of the more common reasons why people are denied and hopefully avoid them.

Good Luck!!!!

BCBS is strong on documentation of behavior modification. They require your primary MD to document on this with each visit. When you do your visits be sure your MD talks and documents on how you are mentally preparing yourself for surgery and what habits you are improving to be sucsessful in your diet.

BCBS wants to know what diet he has you on (low cal), what exercise you are doing, BMI, vital signs and Wt.

Just an update....I was submitted on Monday the 2, denied on the 3rd...so my drs office is submitting all my info to Obesity Law on Friday and are going to have them fight my appeal. Anyone else have experience with Obesity law I understand they are funded by Alergan. BTW my denial was for lack of detail on the 6 month visits to my pcp and unacceptable documentation for my weight history(my drs office used paper charting till 2007).

Hope that this plan works.

Just Tired

Edited March 7, 200917 yr by JUSTTIRED

Just an update....I was submitted on Monday the 2, denied on the 3rd...so my drs office is submitting all my info to Obesity Law on Friday and are going to have them fight my appeal. Anyone else have experience with Obesity law I understand they are funded by Alergan. BTW my denial was for lack of detail on the 6 month visits to my pcp and unacceptable documentation for my weight history(my drs office used paper charting till 2007).

Hope that this plan works.

Just Tired

What type of lack of detail was missing?

Guess they just didn't think there was enough on the form (that my surgeon provided). My pcp didn't always fill it out completely...so my drs office printed out the drs dictation for each visit and it had a lot more detail in it. Soooooo..lesson for all those a/b to submit..make sure you pcp using lots of detail regarding your "diet" and his instructions for your weight loss.

Also my pcp until 2007 only used a graph chart in front flap of chart to track vitals...it does look very jr high...and not professional (ie not on letterhead) so that too is an issue. I haven't heard from obesity law today...i'm trying to be patient. :laugh: just going to keep praying! Good luck to everyone else..and

god bless us one and all

just tired

best of luck to you all with bcbs-il. I am having a nightmare with them right now. I qualify in every way they require, but they declined me because my dr's notes on the 6 month thing weren't "specific" enough. My lap band surgeon has referred my case to an obesity law and advocacy attorney. Now i am waiting on that and really starting to get deeply depressed. My doctor has left her practice so if they deny again, i start over!!!!!!!:mad2:

I finally have an approval letter!! It took almost a year!! I am finally moving forward and going to "LOSE 2 REGAIN ME" !! YEA!!

Congradulations on your acceptance letter. Things will get much better for you now. Good luck.