What is the process???

I have called the insurance company.....BCBS of MO, Alliance, Missouri Teachers Plan, PPO... They told me they have a restriction, but with medical records, letters, and family history, plus being super morbidly obese, they would work with me on coverage. My question... What do I do now? I have asked people for letters. I am waiting on getting those before I take them to my DR for him to write his letter. Does anyone know what my co workers letters should say? What should my Dr. letter say? Do I contact the person I want to do the surgery? Do I wait until the insurance says they cover it? How do I do this? I am so excited to hear they are gonna work with me......I am clueless as what to do next.... SOMEONE PLEASE HELP!!!

Start by selecting a surgeon. Your surgeons office will help you get all the paperwork filled out. Different insurance companies have different requirements. Be prepared for a long haul and be prepared to fight to get your surgery. The insurance companies do not make it easy for you. They will give you many hoops to jump through. Remember the surgery is worth it jump through all the hoops and dont get discouraged if it is not an easy road. I had a hard time getting approved , but I am glad I did. I am two years post op

Your first step would definitely be getting in touch with a surgeon or a surgeon's group, such as the New Start program in St. Louis. A lot of times, you will need to attend a WLS seminar, where you will get a lot of information. Also, it wouldn't hurt to find out EXACTLY what is required by your insurance company. Sometimes they expect your medical records to contain detailed, medically supervised diet records, endocrine blood tests, and a psychological evaluation. Those are things you can gather without selecting a surgeon. Usually you will need a letter of referal to a surgeon from your PCP. Once you have that, and all of the other information in place, you surgeon is often the one who writes a letter to your insurance company for approval and sends all of the paperwork you have given him. It sounds confusing, I know. Just make sure you are VERY CLEAR on the instructions everyone gives you, and make copies of everything. Also, be persistent...you almost have to nag sometimes to get anything moving. If you have the option (based on location, mostly), I'd recommend going through a WLS clinic because they tend to have a complete program that will make sure all your paperwork is together properly. Good luck with your journey! Pamela 352/233/150

I've never heard of them wanting any other letter except that from medical professionals, so I would definitely get your insurance company to explain that. I had to have a letter from my pcp, a letter from a cardiologist and a letter from a lung specialist. I had congestive heart failure but it was under control with medication. I suppose they wanted to be sure I didn't croak on the table and if I did, they had recommendations and clearances from all these other docs. When you talk to your insurance company, write down what they said, the date and ask the name of the person you are talking to and what department they are in. I called and got one answer and then called back later in the day, got another person and got a totally different answer. After that I started documenting just to make sure I wasn't hearing the wrong thing. I would also repeat back to them what I heard them say. Some of the "customer service" individuals got a little miffed at me, but I told them, "I sorry, I just want to be sure I'm understanding the process here because this is the first and only time I'm going to have this done." If they were curt or short and I still had questions, I would call back, go through all the little punch in the numbers thing before I could get a live person to talk to and ask my question. I always got a different person and each time I talked to someone it clarified it a little more for me. Hope that helps. It is a maze of red tape but hang in there. You can do it. I went through New Start in St. Louis. I liked them BUT I found out that there I had to keep calling every week to see where I was out, what they were waiting for, etc. It's the old adage of the squeaky wheel gets greased. If they know you're checking on them, they're more likely to keep things moving. Teresa