Regence Blue Cross/Blue Shield

First of all CONGRATS on your WLS date! I just have to say this because I think is everytime I see your picture--you soooooooo look like your a close relation to Reece Witherspoon. I'm sure you hear it all the time, but i just had to let you know--your beatiful. Steph

I am also a state worker and I went and had my surgery consult with Dr. Jay Jan. How long after everyone saw the surgeon did they get to hear if they were approved from BCBS? Mine will be two weeks this coming Monday and I am just stressing. I keep calling the insurance and they still have nothing from the surgeon's office yet. Any information anyone can give me will be great. Another question is that I know you have to lose the 5% weight. I have lost 30 pounds since October of last year and this has been document by my dietician...what do you thin that my chances are that the insurance will approve me with that prior loss?

If the NP or the psychologist or the PT person or the dietician asked you to send anything back to them as soon as that gets in they will send everything to the insurance company. About three days after I got everything into them did I get a call that I was approved. They have changed the rules about the 6 month weight loss, if you have lost 5% of your weight since you have started seeing them about having the surgery and you are able to document it, you can have the surgery. That really helps for some of us so that we don't have to drive to Portland once a month for a weight check. Call Legacy and check on what is going on. Sometimes the squeaky wheel gets the grease faster by persisting with them. They are only human and are getting inindated with lots of people wanting this surgery now since BSBS started paying for it.

Just an FYI for those of you that have BCBS of Oregon and work for the State. The insurance finally got my information from the surgeon Monday. I called the insurance today and they said that they didn't accept any weight loss before 12-21-05. I lost 20 pounds in the month of November but that wouldn't count. I understand that you are suppose to lose the required 5% but this is crazy. The next documented weight loss was in February and that weight was 303 pounds. Then I have a documented weight of 299 pounds and then 292 pounds. So for me to make the 5% I was like 4 pounds short so I had to scramble calling every doctor I have gone to since the beginning of the year. I finally found that I went to a Primary Care doc and my weight was at 310 on March 23rd. So now I have it documented of March 23rd of 310 pounds, April 21 of 299 pounds and May 22 of 292 pounds. So I have barely made my weight loss at 5.8% even though I have lost a total of 31 poounds but the majority of that wouldn't count. Now I am just waiting to hear from the insurance to see if they will accept that weight. I am just so frustrated and about ready to go crazy. It just seems like the insurance is making this so hard to get it done. So I am still unsure if I will be approved or not.

Michelle: Sorry to hear you are having trouble with insurance company over whether you have lost the weight or not. When I called to get information to start, the clinic coordinator told me that BS/BC was very bad about coming up with roadblocks. Sounds like you found one of these. Hopefully by now you have some good news. Jeanne