Banner Insurance questions

Hi! I'm just getting started with all of this and have a few questions. I have Banner Choice Plus insurance that won't kick in until we have been on the plan for 24 months, which is May 1. I have scheduled an appt with Dr. Juarez for the 6th. I have been seeing my PCP regarding weight loss and he says that he has sent a letter of medical necessity. Is it too soon for this, will they deny me if this letter arrives before I am actually covered for the procedure? Can I have any of the other appts (psych, nutrition, etc) before May 1st, or will they not count them if the actual procedure isn't covered at that time? The insurance company itself is of little help, the people answering the phones are very young. Do they ever set you up with a case manager? That would be helpful. I am so anxious to get this done, I am going for the lap band! I may be overly optimistic, but I'm hoping for surgery in the middle of July. Any input from anyone out there who has had experience with Banner insurance will be helpful! Thanks! Bonnie

The more things you can get done by your consult time the better! My pscyh was done by my consult. Call the surgeon's office to see what you can get done before your appointment. Ask for the insurance rep that works with Banner Health and she'll be able to tell you right off the bat what you need. Your PCP should send the letter of medical necessity to Dr. Juarez NOT to your insurance company. Your insurance won't deny you until they receive a precertification from the surgeon's office asking for surgery. You are set up with a case manager once Dr. Juarez's staff sends your file to the insurance, however this can take up to six weeks after your consult appointment. After my consult, my file was in the medical dictation void for six weeks. Due to the large patient load and they only have a transcriptionist or two that comes out on certain days of the week, waiting for that to get done takes the LONGEST!! During this time though, you can get the other stuff done and sent in to Dr. Juarez's office. Like 5 years of medical records that show your weight and the word "obese" on them. Even if you aren't seeing your PCP or other dr for obesity, they should still write down "obese" or "morbid obesity" on your chart. That is what insurance companies look for. Dr. Barbara Maxwell is the psychologist for Dr. Juarez and Dr. Fang's patients if your insurance covers her. You can call her at 602-262-2222 and she's in the same building as Dr. Juarez's office except she's in suite 307. She is PRO-GBS and is an awesome psychologist. I highly recommend her. The first appt wil be a testing appointment where you take these tests for 3 hours and then the next appointment is when you meet with her to go over test results. The main focus of your pscyh consult is to make sure you have a good network of friends and family around that support you and don't put you down. Hope this helps!! It's an exciting journey!

Trisha, Thanks so much for all the info. This has given me some solid hope and helps me really get down to business. The waiting is the hardest thing, and I don't want to delay the process any more by not getting my stuff finished as early as possible. Thanks again! Do you have Banner insurance? Which procedure/surgeon did you use? How have you been doing? I'd love to know more about your experience... Bonnie