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andrea7374
on 6/16/08 8:07 am - ND
Topic: RE: BCBS of ND...Do they ALWAYS require a 6mth supervised diet?
I guess I will have to wait and see..Ive heard so many different things. My Dr. had told me to write out my history..so maybe just maybe I will luck out. If not I guess I will have to learn some patience
Val_T
on 6/16/08 7:08 am - Williston , ND
Topic: RE: BCBS of ND...Do they ALWAYS require a 6mth supervised diet?
I, too, had lapband, and all I had to do was show I had tried everything under the sun, as you have, for the last 5 years. Your doc should be able to show your weight changes on your charts, which can help some. Good luck!
"Create what you want by doing what you can"

 

disney38
on 6/16/08 6:25 am - West Fargo, ND
Topic: RE: BCBS of ND...Do they ALWAYS require a 6mth supervised diet?
Everyone that I know has had to do the 6 month supervised diet.  It is a requirement before you can even submit for approval - supervised diet for 6 months, psych evaluation, surgeon consultation before any paperwork can be submitted.   I believe I heard that BCBS of MN just switched this to a 12 month supervised diet, so probably the 6 month isn't so bad.  I hear you - I had done every type of diet there ever was, but I needed to see a dietician in order for it to count, and it needed to be 6 consecutive months.  It actually goes faily quick - much quicker than I had anticipated. Good luck to you.  You can call BCBS of ND and ask what your specific plan requirements are, but I do believe it is across the board.

Lori

248/137/140
Lap RNY 7/2/07

To the world you are just one person, but to one person you are the world. 

NDbashful
on 6/16/08 6:03 am - ND
Topic: RE: Insurance and other Questions

I too have BCBS of ND and my approval took 2 week but that was because i had missed on of the sheets that i needed to fill out...with my plan i have to have a bmi of 35+ for 3 years with 2 comob...or bmi 40+ for 3 years...I was just at BMI of 40 when i applied for the surgery...I also had 2 comob to go with the weight...I just keep on calling the insurance to check the status of my application... As for the self pay i can't help you out there..

Hospital stay...nope i went in for surgery at 8:30am was out by 9am and by 1:30 i was on the road home (2hr Drive)...each person is different for the recovery but my was very easy...I was on the pain meds the day i got home and then i took it the next 2 night just to make sure i could sleep...I did have the gas pains but with the help of my heating pad they weren't too bad...I think each dr is different with the length of stay...

I was banded just over 8 weeks ago and have lost over 50lbs (including preop diet)  I haven't done my measurements again yet so i'm not sure how many inches i've lost but i've lost 3 pant sizes...If you have any questions please feel free to ask :-)

High/Current/Goal = 310/215/170

 

NDbashful
on 6/16/08 5:54 am - ND
Topic: RE: BCBS of ND...Do they ALWAYS require a 6mth supervised diet?
I don't know if BCBS had different restrictions for different wls...I have the band and didn't have to do the 6 month supervised diet...I have to provide them with a detailed description of my weight lost attempts for the last 5 years with how much i lost with each attempt...I am what they call a light weight because my BMI was just at 40 when i got approved and i have just over 100lbs to loose...So i would say that if i don't need it then you shouldn't...The problem may come in what your plan requires compaired to what my did...Good luck on your journey...Keep us updated on how you are doing...

High/Current/Goal = 310/215/170

 

HorseLover21788
on 6/15/08 4:25 am - Fargo, ND
Topic: Need Help!
  Ok I am on metformin for my PCOS. For all of u who dont know what this is. Its Polysictic Ovarian Syndrom. Anyway ok so they put me on this and its about the 9th time they have. Well, everytime I crave SUAR LIKE NO OTHER and I GAIN WEIGHT!!!! I have gained around 25lbs or more this last time and I dunno what to do about it. I am going threw the wls procedures and I am with the dietion right now. IF any of u are having the same problem or are taking the same medication please respond. I need to talk to someone who knows what I am going threw!!!                                      Thank You!
andrea7374
on 6/13/08 3:17 pm - ND
Topic: BCBS of ND...Do they ALWAYS require a 6mth supervised diet?
I am curious if all people with BCBS of ND have to do a 6mth supervised diet?  I am just starting the process of having RNY.. Have a full physical scheduled and am attending Dr Bruderers informative session this month..will be making an appt for a psych eval this next week. I hate to be impatient but I have already done..WW, Atkins, Nutrisystem, Meridia ETC over and over the past 10yrs and am so ready to just do this..I really will be disappointed if I have to diet another 6mths in order to get approved. Would love to hear your personal experiences with BCBS of Nd. Andrea
gpete
on 6/10/08 3:54 pm
Topic: RE: VSG people?
Dr. Schmidt at Middakota has only been doing the VSG since this year. The first I heard about it was in March, and by that time he'd only done two. I'm still planning on having this procedure; I too, have lots of reservations about the band and the RNY is way out of my reach financially as I am self-pay. Regardless, every bit of research I've done points me directly to the sleeve anyway for numerous reasons. It stinks that BCBS has that kind of control over what type of surgery a person decides to get. But as far as they're concerned the VSG is still "experimental" so for now I suppose you're stuck with what they'll cover. As more studies come out about the effectiveness of the sleeve, eventually maybe they'll start to cover it. But how long really do you want to wait, you know? From what I've read on the VSG boards, a lot of people have had luck getting their BCBS policies to cover it, but only after lots of appeals and such. If the VSG is still your "first choice" and you're only doing the RNY so that you can be covered under BCBS... I'd recommend heading over to the VSG boards and post a question there about how to push the issue with BCBS, get the lowdown on the appeals process. I don't know a lot about it myself, since like I said earlier, I don't have insurance so it's a moot point anyway for me. But there are some really nice people over there on the VSG forum who have TONS of good information and would be happy to help. Good luck to you on whatever your decision!
andrea7374
on 6/10/08 7:03 am - ND
Topic: RE: VSG people?
I have BCBS of Nd and was told that they will not cover VSG..so I am now more than likely going to have RNY.
HorseLover21788
on 6/8/08 5:41 am - Fargo, ND
Topic: RE: 6/02/08--Anybody from Fargo out here?
I am from fargo as well. My names ashlie and I am 20
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