Questions you wished you'd asked at info meeting?

Hi Paula, GO TO SUPPORT GROUP on Monday 11/6 at Scottsdale North Hospital! This is a great place to share your story as well as get advice. I have a good friend who has been battling with UHC for months now. She is at the 2nd appeal level. However, at support group I have met several people with UHC/State of AZ (benefit excluded) who have fought and won! Make sure you do every study out there! Sleep apnea is a helpful diagnosis as is hypertension, high cholesterol and the Grandady of them all, Diabetes. If you have some or all of these and do your 6 month supervised weight loss program I'll bet you get approved. Make sure you get the Doctor guidlines from SBC on how your PCP should document your 6 month progarm or, better yet, go to SBC's Dr. Emershad. If you have your PCP do it EVERY visit must be documented as PRIMARY reason for visit: Weight loss/management. Also go EVERY 30 DAYS at minimum. If you go over say 31,32 days they may make you start all over. Good lucj, Mary

Paula, Don't be too discouraged that your insurance has a WLS exclusion. My insurance also had the exclusion and I was approved. You just need to have the proper documention (lots of it helps!) for your surgery... like a letter of medical necessity from your PCP, documentation of prior weight loss attempt... Jenny Craig, Weigh****chers, Gym Memberships... etc. When Scottsdale Bariatric called for pre-authorization with insurance... BCBS of NY wanted 6 months of documented weight loss. So I went to my PCP and she faxed over 12 months of documentation talking about weight loss and all my weights and so on. Then I was approved. SBC will notify you right away... which was so nice! If you don't have the 6 months I would suggest you just get that started now... so if the it comes up you will have a few months under your belt. A friend of mine just got his consult at Scottsdale for 11/17... so he is on the road to being skinny also! Today is my first day home... and I have to say Scottsdale Bariatric really impressed me... to the initial consultation, to the support groups, pre-op class and the discharge class today... Dr. Blackstone is truly a wonderful person and in my eyes, a life saver! Good Luck to you with your journey! ~Nicole

Thank you to all for your info - it is much appreciated! Nicole, glad to have you back on board (no pun intended ) - and glad to hear all went well. Re insurance issues - our insurance benefits book specifically spells out this exclusion. Hubby called to ask about 2007 benefits and while talking to them, they told him that bariatric surgery was NOT specifically excluded...hummm... So I called them and she was very specific that it was not excluded, but was okay with clinical review. So then I asked about 2007 benefits and she said that it just said will not be covered - left off the except w/clinical review - part of the sentence. So then I asked what happens if I get this all approved etc in 2006, but surgery can't be scheduled till 2007, and then she said "probably okay" -- ugh ugh ugh . So basically now I don't know what to believe, so I'm just going to assume it will be covered w/clinical review, medical necessity, etc and move things along. I attend info seminar Nov 5th, have dr's appt with my PCP (who is supportive) on the 9th to go over her part of the paperwork, etc. Then I'll submit it with tons of backup material, and we shall see... Keep fingers crossed! Thank you!