Hi!  I don't think I have the PPO plan at Harvard Pilgrim, but I do have Harvard Pilgrim.  I got approved pretty quickly for VSG, and I was sweating it because I thought I was iffy on hitting the requirements.  My official BMI, based on the surgeon's scale, was 39.7, and I have zero other health problems.  I do have a history of documented, supervised weight loss attempts, so I don't know if that helped.  I started the process on May 20th with my first appointment with the surgeon, and I'm having surgery on August 13th.  The lag time actually had nothing to do with insurance; it was just waiting for appointments to see the specialists. Some of them were pretty booked, so I had to wait for a month to get in.  I had my final consult with the surgeon on a Monday, which is when the office submitted my application to insurance, and I had a surgery date the next week.  My understanding is Harvard Pilgrim is notoriously fast with the turn around!

Good luck to you!

I don't have a full answer for you, but I'm a little further ahead than you are -- hopefully we can learn from each other's experiences! I have been working with the Weight Center for a few months -- went to an info session in April and my first appointment was at the beginning of May. After the initial appointment I was sent to meet with an MD to screen out complications/contraindications, and then was referred to the pre-surgical nutrition group. I understand that I'll actually meet with a surgeon when I've finished that, probably at the end of August/early September. I'm afraid I haven't got a clue how long it'll be from then until surgery, but I'll report back when I hear more!

My recommendation would be to be very proactive about scheduling appointments and following up. Every time I have been in, they've told me someone will call me -- and then it takes them weeks and weeks to call back. Going forward, I'm going to be making those phone calls myself.

Steph! You were in my immersion day group! I recognize you from your photo :) I am meeting this week with Dr. Shah as well! So far things are going super well for me, too and everyone is so nice! Hope everything continues to go well for you, too!! :)

Thanks for the reply! - Jae

I have seen a lot of posts about BCBS but none about Harvard Pilgrim.  I am wondering what experiences others have had with RNY approval if you meet the BMI of 40 requirement.  Trying to figure out what my turn around time will be.  

Hi,

I am new here and just had my first consult at MGH weight center today.  I met with Dr. Butsch, nut, and psych and all seemed to suggest RNY as my best option.  I have not been assigned to a surgeon yet but I am eager to hear other peoples experiences.  When they asked about a preference I suggested Dr. Pratt but they said that she is doing more administrative work now and only doing surgery on very high risk patients or complicated cases.