BCBS PPO requirement of 5% weight loss

I was informed by a friend *****cently had surgery and went to the Salem support group meeting last night that the requirement for 5% weight loss can begin at anytime and not just after your initial appointment. Is this really true? Does anyone have more information on it?

Call Lori at 503-561-2129 or 503-561-5286 Salem hospital Bariatric clinic and ask her. She is the coordinator for Dr. Nair. I was the 2nd RNY surgery in Salem and my 5% started from my consult appointment with him but they have changed a lot of the rules in the last couple of months so I would call the Bariatric Clinic and found out for sure. Lori can answer most any question you have. Good luck, Mary

When I had mine done, I didn't need to lose a %, just show 6 months of diet history (under doctor supervision) within the last two years prior to trying to get surgery. Lori

I am going to Legacy Good Sam through bcbs ppo through the state. The way it works is you can start to loose before hand, but once you start weighing in there at the clinic they document your weight. If you weighed in at your doctors with in the last 6 months and have lost 5% you can use that as your starting weight. The whole thing is, in the last 6 months you have to have lost 5%. For example, my start weight at my doctors was 341.6, but 2 weeks or so later at my first appt. at legacy good sam, i weighed 340.1. If i hadnt have been able to loose the weight with in six months i could have had my regular doctor fax my start weight if it would push me to that 5%. Just a heads up, they dont send anything to your insurance until you hit that 5%. However, they sent my info in and like a day and a half later was approved. Sorry for the long drawn out explanation, but i hope it helped. ~Peace~ Amy

Wow! I'm glad I didn't have that requirement because I wasn't able to lose but a pound -- no 5% for me pre-surgery. I got to use extensive diet history within the past two years. No way I would have qualified. That's terrible. I'm probably one who needs it worse than most (because I can't lose on my own) but wouldn't even qualify. Go figure! Lori