New Here and lots of questions regarding approval!

Hi everyone, I have been lurking on this board for the past year and a half and actually found Drs on this same board from all of you veterans' comments. This board helpoed me make up my mind about setting my goals and deciding to live instead of letting myself to die from obessity complicaitons.  I just attended my first meeting last week and my only regret iks that why didn't I go through this sooner and changed my life quality and style. I have already registered for first Dr visit. I have Empire blue cross of Maryland and even though it says BMI of over 44 and Dr's approval is covered (inthe guidline brochure, Page26  http://www.empireblue.com/provider/noapplication/f2/s5/t9/pw _ad080419.pdf ) the Dr still mentioned we have to have a 6 months supervised diet. Do we? Can I get approval with showing history of going to Hopkins endrocronology offices, nutritionists and also being under supervision during pregnancy for gestational diabetes and not go through the 6 months? I am sorry that my post seems so here and ther, but I have lots of questions and so many worries regarding Empire blue corss. Anyone with any information would help me a lot.,  Thanx Ellie

Hi Ellie, Welcome to the board as a poster rather than a 'lurker!   It's always exciting to have a lurker come forward. Even though many of us have the same insurer, the way the policy is written may be different for each emploiyer, so there's not really a universal answer for your questions.   If the doctor you have chosen is going to be the one who works with your insurance they are best prepared to know or determine what your insurance company will require.   Make the doctor aware of what you have done and then work with them to get your approvals. Best wishes as your WLS journey continues. Hugs, Mo

Hi Mo, Thanks for the encouragement. I willd call  insurance company tomorrow and see if the codes are covered, I called today and they only had nurses available due to being Sunday and all. I originally had planned to go with Dr. Schewitzer but he informed me he is out of plan with BCBS. I hope to get where you guys are. The six month wait is not as much an issue, I guess I am in a hurry to be more on the loser side faster than usual. Do you eat any carbs these days or do you still restrain from  fruits and carbs? Mo, Thanks for all the inforamation, I wish I were in Baltimore area so I couyld attend your support group or choose another surgeon from center of excellence (which  so far I don't know what that means anyway)

Ellie, hi. (First of all, I have Carefirst BCBS but used Dr Schweitzer for myt band 2 years ago.  Even though he is out of network, if you like him, you should still consider him.  Insurance will still cover the in-network amount, then your share will be only something like 20% of the amount left over (so  its not like you have to pay anywhere near all of it.)  I think he's awesome. And the 6 months?  If I understand it correctly, its six months with monthly documentation, not necessarily six MORE months form the time that you start.  So, if its recent, with monthly documentation, you may already ahve that part handled. Good luck.  Barbara

Where are you? I had Dr. von Reudin at GBMC. He is fantastic!

Aime, I llive in Rockville and work in Bethesda, so for the first time in my life I wish I was closer to Baltimore area and either Dr. Von Reudin or Schewitzer. It is not only the day of the surgery or office visits, it is more the suppport meetings, personal trainer, threapists nutritionist and all the post care that I am concerned about the commute. Do you still go to support meetings? I am sorry i forgot to ask if you did RNY or lapband?

I suggest that you check the BCBS web site and see if they have a list of participating surgeons.  Then go thru the list on THIS site for bariatric surgeons in Maryland.  You will most likely find some matches.  It seems that most of the bariatric surgeons now have web sites where you can get information about their information sessions, seminars, and support groups.   I had my surgery at Sinai with Dr. Li. (  http://www.lifebridgehealth.org/sinaibody.cfm?id=1361 )  I know that at that time they were BCBS participants.  I do not know if they still are.  I have heard wonderful things about all of the other doctors mentioned by other posters.  My only concern for you is that getting yourself from Rockville to Baltimore for support group meetings might be difficult.  I had to drop my attendance at ours because I simply cannot get from my job in Largo to Baltimore in time.  Have you considered a DC area doctor?

Thnaks for all the information. The Dr. that I have gone to meeting this past week seems a really good Dr. the only thing is that it is not in John's hopkins hospital, they have opened a surgery center close to Shady grove hospital and Dr. Schitzer has had 1500 lapband which amounts to 3 times this guy. Also, I really want to be able to go to meetings and support group functions, because as you see I have already found so much information form all of you, not to mention the support and I am in the most early stages, let alone having the support from all that have already been though this once I do the surgery.