Hello All, New member here

    Hello everyone. Noobie here. Just started this journey last wednesday at Siani. Wanted to stop by and say hello. I am sure I will have many questions. I am just starting to try and find out what my insurance needs to have this procedure. All I can get out of them at this time is a note from my doctor stating that it is a medical nessesity. I know there is more to it than that lol.. A little about me. I am 29, 6'1'', 405lbs. I am a IT consultant. Hope to make some new friends here. Ciao

Hi and Welcome !!!  I also had surgery at Sinai and Dr. Chua is my doctor. I'm 7 weeks post op. I was afraid I wouldn't get approved because of no co-morbidities. I have no high BP, no diabetes, and my BMI was 42. I was approved with United Healthcare UMR within 72 hours. I went through 3 months of visits with the dietician, a psych eval, and bloodwork prior to getting approved. Have your primary doctor add that the extra weight is hard and bad on your joints, your depressed because of your weight, idf you have a family HX of high BP, heart disease etc... add those things. Dr. Chuas office is VERY experienced and knows how to present cases. Don't worry. Good Luck........................Shari                                                          RNY Oct. 15, 2007

Thanks for the reply. I am glad to hear more good things about Dr. Chua. I am a bit concerned though about my insurance. I called them twice about precertification for the surgery and the best I could get out of them was that it was medically nesessary.  They said there were no  other requirements. Has anyone ever heard of this before?

Hi and welcome!!  Ask your insurance to send/fax/email you the actual criteria they require for wls... My insurance gave me that same line about only a note from the doctor and I wasted a month thinking that before I got somone on the phone that knew what they were talking about :). Best of luck to you and keep us updated!

Thanks for that tidbit. Im going to get in touch with the insurance again to see what I can come up with.