A newbie, please help
Joyce G.
on 7/26/03 10:22 am - Lakeland, FL
on 7/26/03 10:22 am - Lakeland, FL
I've been thinking about this surgery for a long time now. I have bc/bs ppo, so hopefully I won't have a major problem there.
What I would like to know is:
What are the steps AFTER you find the doctor??
I do understand that you have to be at least 100 pounds over weight??
How long does it usually take from the time you first see the doctor til surgery, if things go well with the insurance??
thanks
Joyce:
Every situation is different, even with the same insurance company. I also have BCBS PPO but mine is from Massachuetts even though I reside in Florida. It was exactly one week for my claim to be approved. Each surgeon has different requirements. My original surgeon insists on a lot of tests. My first visit to his office was 3/8/03. I finished my tests the last week in April but changed surgeons due to a situation beyond the original surgeon's control. I saw my present surgeon on 5/8/03. He required a letter from my PCP who was on vacation but got the letter to the surgeon upon his return 3 weeks later. Once the claim was presented it was approved quickly and I was assigned 7/28 as my surgery date. All in all it took 5 months. Some folks go quicker, some much longer. As for the steps your surgeon will tell you exactly what you need to do. Joe in Clearwater.
My surgeon first asks that you call your employer's insurance coordinator to make sure they cover the surgery or that it hasn't been specifically excluded. Many insurance companies have different prerequisites before giving approval.
I had my first appointment with his nurse practiontioner and she gave me a lot of information and a list of tests that he requires. Once all of the testing is done and the paper work is complete his office submits for insurance approval. Depending on the insurance company it can take up to 3 weeks for approval.
Anita R.
on 7/30/03 3:07 am
on 7/30/03 3:07 am
Joyce -
I also have BC/BS PPO and actually found a lot of information online at this site under the heading "your journey". I actually contacted my insurance company then set out to make my appointments for the eliments I have to include a psych eval. My primary has been also very helpful during this trial he did a complete physical to verify if there was anything that we were unaware of and take care of the problem prior to submitting to the insurance company. The staff at Dr. Overcash's office have also kept me on track with what I need to turn into them for the insurance submital paperwork.
I do recommend talking to your primary physician and if you have any eliments that are life threatening could make way for you to have the surgery without necessarily being over 100 lbs overweight. It is really different for each individual. If you have any questions - please feel free to contact me. I will offer whatever advice that I can. Best of luck in your WLS journey!