BCBSIL & RNY

Greetings,

Does anyone know if BCBSIL, is really good about approving RNY?

I tried getting approved for DS (what was I thinking)...and was denied.

In few days, my Drs office will be submitting for RNY.....

Just wondering do I have a chance. I have met ALL requirements.

Let me say this, if DS is what you want, then fight for it, there is a lady on the DS board I believe her name is Diana Cox, she helps folks fight their insurance to get approve for DS.  Please do not just accept any surgery if that is not the surgery that you want.  You will have to deal with the after life of WLS, not the insurance. You might not have it right away, but I believe if it is what you want, taking the time to fight for it, it so worth it.

 

I have bcbs of il & got approved within 3-4 days of submission.  I thought about DS as well & fighting for it, but decided to go with rny instead,  but I really liked my surgeon & he doesn't do DS & from what I could see, the DS surgeons are in Chicago, which are 4 hours away, which wasn't logical for me at all.

That sounds great....my surgeon does DS.

I just dont think DS is for me...I need to change the way of eating..and being able to eat anything really defeats the purpose.

I got freaked out with the 75% of your stomach being GONE.

I am praying that I get approved. I have completed everything BCBS wanted....

I bet went you were approved you had to complete a 6 months diet right? Well as of 7/1/09 they are requiring 3 months.  I have completed about 5 months...and my BMI is 60 so I should be okay with getting approved.

I will keep ya posted.

um actually no, I was blessed to have a surgeon who knew how to jump through those hoops without doing all of that.  I filled out a questionaire that listed all of the approved diets & I just answered questions to those that were applicable. Didn't have to turn in any receipts, provide additional proof or anything.  Mine was 54 when I started & got to add a nice co-morbidity of high blood pressure to that, thanks to my referral appointment from my pcp that I had to do for the surgery, how ironic is that?  So, the only things i had to do were the appointments with the nut, phys therapist & the psychologists.

Most insurance will approve the RNY with no problems.Had I submitted for RNY back in May I would have had the surgery already. But noo listening to the ********urgeon I had I submitted for VSG was denied until I can't appeal anymore. Shoot insurance says they would pay for any surgery besides VSG and that included the DS, but I am going to stick with RNY. These surgeries are tools and if you work it to your advantage then you are good.

By the way I was approved 8/28/09 they had signed me up with a date of 9/8/09 and after all that *****ing I did I had to ask them if I could schedule for 9/28/09! It's all good though because I have 4 kids and the husband is with his mother and it doesn't look so good for us two right now and I have to make sure someone will be able to care for the kids.

But anyways, don't let anyone make you feel bad if you change your mind about what type of surgery you want. You are going to be the one living with it. DS is a great surgery but it's not for me and I could have been approved for it without any problems, and there were many posts on here bashing me for my decision to have RNY. But anyways I think you should be fine for the RNY.