Fighting for the procedure I want

My insurance didn't require that at all.  I just had to list the things I've done and my PCP had to send them confirmation that I have tried those things.  That combined with the 3 months nut counseling was enough.  Then again, every insurance company is different.  Good thoughts sent your way! :)

 I would call again.  Someone has to be able to see what procedures are defined as being covered.  This is no secret in the paperwork.  Now, if they still can't give you an answer, you want to remember that you are a "customer" at Dr. Stewarts office.  Unless they can produce specific documentation to your policy or Dr. Stewart (not staff) can give you a damned good reason why you shouldn't do the DS, then insist that they submit for approval for DS and see where the chips fall.

Good luck!  It sounds like you are on the right track.  Please keep us updated once you talk to your surgeon!

I am in a similar boat right now with BCBSTX.  My BMI is 44.6. but they require 50 or above. 

 Good grief - you're stalled over 0.4 BMI! I sure hope they come to their senses. Good luck!

I have health insurance through BCBS-NC & they require a BMI of 50 for the DS. Mine was 44.5 when I first submitted the insurance paperwork. It took me almost a year, but I finally got approved for surgery. My initial request was denied, a peer-to-peer review was denied, & my Level 1 appeal was denied. I finally won my Level 2 appeal. It was an extremely stressful process, but it can be done. Some insurance companies make things difficult & hope that you'll give up. Don't give them that satisfaction! If you fight, you can win.

 I do not know what your insurance requirements are, but I too am a light weight, BMI 42, and just met with Dr Stewart. I am revising from band to DS. He is a reasonable man. We discussed my history of obesity, why I was wanting DS over RYN, and my complications with the band (bmi 42 when I got band, gained all weight back with complication). He discussed pros/cons of procedure and told me for his patients who have low bmi he tends to leave the common channel slightly longer (~125). I don't know who you spoke to on the phone, but stop stressing about it. Dr Stweart and only Dr Stewart has the final say in what procedure he feels is appropriate for you on an INDIVIDUAL basis. And from all I know, surgery consults are not completed over the phone with a screener. 

Let me know how it goes!  
Auburn

Hi I have Anthem, and the CPT CODE my doctors office used Anthem is saying it's considered Imvestigational/Experimental... I was wondering if you still had a copy of your 2nd Appeal letter OR IF you could offer any suggestions on how I can get approved....I have a dilated Stoma, Gerd, Reflux, HBP. Lower back problems, my BMI meets the requirements...Also this is for a Revision to RNY...I APPRECIATED ANYTHING YOU CAN HELP WITH.