Waiting for Insurance approval - RNY to DS, BCBS NC

Hi all,

My paperwork was submitted on Tuesday and I'm waiting to hear back from insurance.  I had my RNY in 11/2007, lost down to 145, but am now back up to 235 (90 lbs, YIKES!).  Going through Dr. K requesting a revision to DS.  So the wait/weight is on. (haha, I'm so punny.     )  Anyone else have nay luck on getting approved for a revision through BCBS NC?

Good luck on your revision and please keep us posted on how you are doing  

Don't have any advice but I do have a question. Did you have to "go through the process all over again?" And Btw, good luck!!!

Hi Leah,

I did have to get all my medical records together as well as a UGI, and new psych and dietian exams done again.  I'll post again once I hear back from insurance.  Thanks!

Hello, Carrie W. I also had my RNY in 2007, but I only lost 85lbs. I was exercising everyday and eating healthy, but the weight came to a standstill and, ultimately, came back. With a BMI of over 50 at the time, I feel that my surgeon should have either requested that for me or sent me to a surgeon that does DSes. From what I hear, BCBS (which is what I have) does approve revisions. I called the CarefirstBCBS and they said as long as the revision is medically necessary, then they will cover it provided you take care of all of the prerequisites. I just started the process for my revision and am really hoping that I will get approved without the 6 months of supervised diet.

I wish you all the best and hope you will hear good news soon.

BCBSNC was easy to get through for me because my BMI was just over 50.  50 BMI is the magic number for them.  I think you can get get it approved for under 50 BMI but you will have to fight (and appeal) for it.  Good luck to you.

i have almost the same story except im going to see the doctor at the end of the month and my insurance is BCBS MI,  so worry about the whole process with so many questions, because you've already started it can i ask some of them to you, ...  i live in AZ and im hoping the dr that does the DS's here will be alright to do one on me, im at 40 BMI, i went for 250 to 137 with my RnY in 2009 then got pregnant 8 months later and gained back this weight to make me 220.  was is hard to talk your dr into giving you a ds because your a lightweight, how did your first appt go with him, let me in on any other tips thanks