Keep your fingers crossed for me !! :help:

Hello everyone, Well, everyone is right. Dr. Chua and his staff are great. They sent in my paperwork on Friday to the insurance co. I have medicare as my primary and BCBS of IL for my secondary. I've heard they can be real sticklers. I am going for the lap band. I went through all of the paperwork last December through UW hosp in Madison (I have several other doctors there) and they submitted it to the insurance. The insurance came back a few times stating that they needed my BMI and comorbidities. UW sent it a few times. Then I got a call from UW stating that they could not do the surgery because Medicare required that the surgery be done at a Center of Excellence, which they are not. They appoligized for their misunderstanding which I understood. So I had to start all over. I was referred to Dr Chua through the nutcracker I was already seeing for the UW program. So here I am today, hoping and keeping my fingers crossed that the insurance doesn't try any fast ones on me. I called and told them that Dr Chua's office would be sending in more info. They said on the phone that they just needed the BMI and comorbities. My senses tell me that this might just be the beginning of frustrating times. After reading several other websites that deal with the insurance approval I'm afraid they will reply asking for more, then again, again and again. So if you could all keep your fingers crossed for me, I would greatly appreciate it. I would really like to get the surgery done before the end of the year!! Thanks for listening, Sandi from Racine lap band hopeful

Hi Sandi! Yeah for you!! You won't be disappointed with the help you get the Dr. Chua and his team. They are all wonderful people and they will fight for you! Insurance is a touchy thing. Mine went through (BC/BS) without a hitch, but they've become more sticky since then. Trust in them, have faith, occupy your mind with other things, and when your paperwork does get submitted, try this: I called the insurance company at least once every day to check on the status. When you call, your call must be noted there. I think they got tired of hearing from me. It was less than a week when I got my okay, then a couple weeks until surgery. Once it's done, you'll look back and say it was all worth it! I thank God every day for Dr. Chua. He has totally changed me, my life, and my attitude towards life. I'm seeing him Friday. He is doing my "flubber removal" on the 24th! I can't wait either! If you have insurance questions or anything like that, Tammy is the gal you want to speak to at his office. She's FABULOUS! Good luck and be patient (as much as you can!) Soon you'll be a "big loser" too!!!!!!

Well, It's a NO go !!! I got my denial about a month ago. Needless to say I am very depressed. I have been playing this game for almost a year now with two seperate clinics. BCBS of IL stated they needed more documentation and again included their whole list of requirements needed. When I called Dr Chuas office to discuss this she seemed to think the list was so long, then asked me if I wanted to persue it further. That didn't help my outlook on things. Guess I don't have the necessary documentation for the 12 month diet. I have over 2 of the co morbidities but they are all basically controlled with medications. I guess I have to be on my death bed for them to cover the surgery. I guess I am just venting here but when I went to the clinic in Madison and the one in Milwaukee they both felt I would be approved with no problem. (I am a 3 time cancer survivor and have alot of health issues and a disablilty that makes weight loss even more important) They both got my hopes up tremendously (I'm sure they really felt I'd get approved). What I"m having a problem understanding is, they both knew what insurance I carried and had a copy of their requirements. Why did I go through all of the pretesting (which insurance paid for) with each of them before they submitted to the insurance. Then when it was submitted to the insurance they didn't make sure that all of the criteria wasn't met. They insurance paid for all of the testing, nutritionist, nut cracker, doc etc. Don't they go over your insurance co's criteria and make sure all of the requirements are met before they send it in? I went back to my primary doctor and he unfortunealty wasn't of any help. He said I should see Dr Chuas office about going on Medifast. ( I had asked him about Medifast) Of course I didn't think Dr Chuas office prescribes Medifast but I called, and got the answer I expected. I have since called my PCP back and got an RX for Xenical, tried it once before, just another stall tactic for him. Think I may need another Dr who will push for me for this surgery. He knew I was trying for this surgery (he also had the Ins requirements) but would make my appointments 3 months apart. Not thinking I was going to be denied (based on what both clinics said) I didn't say anything. Sorry this so so long, and probably confusing to you all. I am just lost, I feel like just a big fat looser !!! Oh and I haven't been morbidly obese for 5 years. Guess the insurance company really wants to see me suffer!!! I am a three time childhood cancer survivor. I have fought all of my adult life to keep my weight down but as I am getting older my activity level is sinking. I have a prosthetic leg above the knee and getting around is getting harder and harder. Thus I am getting bigger and bigger. I was wearing a temporary socket because I was anticipating the surgery anytime now and didn't want to have the permanent socket made (Ha was trying to save the Insurance company money) Well today I was sitting on the floor and turned just the right way and it cracked into a few pieces. I am so Frustrated with all of this that I don't know if or when I will attempt to get this fixed. I have always been an active amutee but getting old and fat sure put the brakes on this. AAHHH !! LOL Oh well just another Crappy day. Didn't think things could be much worse then getting denied for the second time. But I guess each day is a new chapter !!! Again, sorry for this negative post, but I just had to vent. Don't know where to turn, thought you all might understand some of the stress this entails.