insurance q's on qualification and Dr in network for bcbs tx

Where do I even begin...I found out through my ins I have a 12 mos failed dr suppervised wait before i can think about being approved for rny wls. I called a dr close and they arent in network for me and basically a cash office. I was looking at walton and broussard..(sp?) at weightwise. Not sure if they  are in network or not...how do I find out this...I have the year wait and not sure how to go about that either. If I lose really good then they wont approve me based on my bmi.  I am borderline as it is. I wouldnt be in this boat if i could lose even with dr help, so I dont wanna seem like I dont wanna even try. What do I do??? I am at 245 bmi 41. Help Help ..thx

You should be able to determine which doctors are in network from the BCBS website. 

I'm federal BCBS and Dr. Ronnie Keith at Oklahoma Weight Loss Options, in Norman, is in network for me.  

When I originally checked Drs. Broussard/Walton were not and would have been a cash pay only.....but that could have changed.  

If you have documented proof of trying and failing at weight loss, i.e. thru your family doctor,  Weigh****chers, exercise regime, diet pills, etc etc.  Then you may be looking at much less than a year.   Also if you have other health issues such as diabetes, hypertension, sleep apnea...all of these are taken into consideration as well as your BMI.   

I had over a year of documented WL failures, when Dr. Keith's office contacted BCBS my surgery was approved without an additional waiting period. 

Good luck...

I was looking at them because the one locally was outta network and was self pay, so hoping Broussard/Walton...Would you recommend Dr Keith..honestly...any q's that you didnt like about him? Need to look up his office maybe..it's ayear out but wouldnt hurt huh? Thanks for your reply.

I started out with the Edmond group.

Went thru all the steps; seminar, counseling and psychological testing, exercise physiologist, initial exam, group support meetings...was ready to schedule my surgery. 

Then unexpected family issues forced me to delay my surgery...for a year.  When I was able to get back with the program my family doctor recommended Dr. Keith.   ( see my reply to your other post..)   

At the time that I started with the Edmond group they required you to loose a certain percentage of your weight prior to your surgery.   This is designed to shrink your liver and make the surgery easier to perform....easier for the doctor and safer for you.  

Dr. Keith does not have this weight loss requirement.   But the pre-surgery diet that he has you follow achieves the same result.... for me personally this was a far less stressful way to go. 

Dr. Keith is totally NO nonsense.  He is definitely gonna tell you like it is....and you may not want to hear what he has to say.  He nicely chewed my butt at my one month followup.  But I wasn't doing what I was supposed to do and NEEDED to have my butt chewed.  

I also liked the fact that I would have the surgery in a hospital (Norman Regional)...so if anything went wrong I didn't have to be transferred. 

I believe both the Edmond team and Dr. Keith are very competent surgeons....Dr. Keith was my ultimate choice and one I'm still very happy with.        

 

ty Debbie..I will check around and get some more imput on both drs