Approved but....

Having started out with a BMI of 38 with co-morbidities(diabetes, high bloodpressure, high cholesterol, etc) I had to go through a new process for Blue Cross to get approved. I had to lose 10% of my weight to show that I could follow a diet program to prepare me for post-surgery eating. I verified up front that the process of having this procedure done would be based upon my original BMI of 38 and not what it ended up at after my dieting...they said...of course. Obviously for me diets can work but won't hold long enough that it is a permanent option for successfully losing my weight. Not only did I lose the 10% but I think I lost 13% which I was impressed with...but no way I could enjoy life eating that way. My PCP approved the process...I got the referral approved by my BCBS. I go to call the Bariatric Center that I am approved for and they say that it is very unlikely that any of the surgeons at this facility(CDH) would be willing to do this surgery on me because of my LOW weight! I was floored. She said that she would see if any of the 5 on staff would be willing. I called back to my referrals department to see what my options were if they turned me down and she was shocked...said that 2 of the surgeons are staff members of Dupage Medical Group and 1 of the two has to see me. I called back CDH and the same individual as before said that she would ask the 2 surgeons if 1 of them would be willing to meet with me. She refused to schedule me for the approved consultation until she heard from 1 of them. I get the impression that this is not the normal treatment received from CDH but I am at a loss to know what the heck to do now. I have a call in to my PCP to see if he can kick them in the pants or not. Any feedback would be appreciated. Thanks.

Gary - I am sorry I do not have any advice or feedback but wanted to welcome you to the board and say congrats on your approval. Just wondering, will you go to a different center if none of their surgeons will operate on you? Is this where your wife had her surgery? I was just being nosey on those questions. Nancy

I'm not really sure what I will do next. I will leave the initial responsibility in the hands of my PCP as he will need to alter my referral to go somewhere else. I know that this area has a lot of options available but I'm not sure which ones will be acceptable to my Medical Group. My wife had her open done at Loyola by Dr Brems who is no longer doing these surgeries so that option is out. Will post if I hear anything new but right now I am trying to stay happy with the fact that I have the necessary approvals...just no one with a willing knife to cut me open hehe!

Gary- My BMI was 38 also. Forgot that in first post. Michelle

Gary, I had my surgery done at CDH and I am shocked at the response that you got from them. I would keep persisting. Dawn

Well...am guessing that my PCP put some heat under someone as I am now scheduled for my consult (supposed to take 2 hours) on the 10th. Hoping that he doesn't have a long wait for scheduling of surgery. This is with Dr. Spitz at CDH. Any recent experiences with him?

Gary, Yes, the consultation takes 2 hours. You will be seen by a dietician and the nurse and lastly the surgeon. Personally, I had Dr. Klem as my surgeon but have heard good things about Dr. Spitz. CDH does also have information meetings and a support group for PRE-ops that meets on the first or third Monday. If you call them at CDH they will let you know. Good luck at your appointment. Dawn

PLEASE, PLEASE, PLEASE !!!!!! Hang In There. Try another center!!! Dr. Sydney Rohrscheib does not ask for this "BOGUS" cost. I have BC/BS of Illinois, was approved with no money up front.I was approved in 1 month and had a date. He has great Surgical Statistics and Helpful, Understanding Office Staff. He did my Lap Band, on 8/17/04. I am down 110 lbs. They hold a forum to EDUCTATE you about every choice and opportunity. The next one is 8/18/05 @ 6:30pm. I am the guest speaker. I will be there for your questions. I do not work, get discounts, or get paid for anything concerning these discussions. I am there to tell you about my experience and share my knowledge concerning the Lap Band. Call and make an appointment for the forum. 1-866-622-9222. Tell them Michelle Wade referred you. Make the call. It will be the MOST IMPORTANT PHONE CALL YOU EVER MAKE!! If you have any other questions (besides what I have written) email me at [email protected] & put Bariatric in the re: space, I will open it then. Michelle.

Thank you for your response. I will hold out hope for CDH and see how things go at my consult. I have heard good things about the program at CDH if you ignore my first couple phone calls. My wife also had her PS done there and it seemed like an ok place...if you ignore the parking issues. If I end up having problems or not liking something about CDH I will keep Dr. Rohrscheib as an alternate option. Thanks.