Excellus BC/BS

Does anyone have Excellus? Just wondering how long it took to get approval and if there was a minimum for supervision. I called insurance company and got paperwork and says minimum 6 month supervised. Does that mean 6 months in the program or all together. Any help would be appreciated. Thanks, Christine

Hi Christine,

I have Excellus.  I guess I was an exceptional situation...they hadn't approved the procedure for the lap band for ANYONE until November 2006.  My process took 2 years.  Once approved and once the doc's office was on board and realized the process was approved, it was about 6 weeks or so.  RNY procedures are being approved quickly also, maybe quicker than banding.

Best of luck!

I have Excellus also, my appointment with Dr Boss is Tuesday.  I will let you know the wait after the appoinment.  I have been at this since December, although my first surgeons left in February and I had to move to the Highland group and start again.  I have been cleared by the nutritionist and psych. after having 2 nutrition appoints and Highland and 2 at General.  It has been a long haul and I am ready for this.  The nutitionist told me after the appointment with the surgeon it is usually 3 weeks for approval. I hope she is right, I will let you know what he says. Karen

I have Excellus BCBS and while there were just a couple of minor stalls (asking for an additional note from PCP to document necessity and an additional psych eval, they were pretty quick. If you have 5 yrs of diet history that can be documented by your PCP, you won't need to do the 6 mos of supervised dieting. Best of luck to you!

I have Excellus.  I had my initial consult with my surgeon in February this year.  The requirements that Excellus demanded were: 1. The letter from my primary care physician stating that I had been under her supervision for weight loss issues for at least six months.   2. A BMI over 40 (and if I had any co-morbidities they needed to know about it, I had a sleep study but I don't think they required it, it was mainly my primary that asked for it)  3. The consult with the nutritionist. 4. A psych eval.  They would not accept the psych eval that was done by the clinical social worker at my surgeon's practice.  I had to have it done by a Psychologist or Psychiatrist.   Once those things were all collected and sent in with a letter from the surgeon, they approved me in one week.   Once approved, I got a date almost immediately and my surgery is coming up on August 6th.  That whole six month diet thing can be bypassed as long as you have a primary doc who will write a thorough statement detailing your weight loss efforts and give month and year that you were seen for weight related issues or the months and years that you participated in a weight loss program.  Some docs won't write it, others will.  I was lucky that mine would.  I actually wrote out the full history for her and she wrote her letter based on the info I supplied.  (However, my medical records were destroyed last year when her office was flooded, so she didn't have any records to rely on.  She knew that I'd been her patient for ten years and that I'd struggled with the weight issues, so she just let me give her the rough dates)  Start to finish, less than six months for me from consult to surgery. 

Today I saw the surgeon and I have a surgery date of August 15th.  They said the insurance process from Excellus would be one week. Thanks Karen