I'VE BEEN APPROVED POST IT HERE

did you have to do a 6 month diet

Hey there, I have been approved!!! I have Aetna PPO My paper work was submitted on Tues June 26th and I was approved on June 29th. I scheduled my surgery for July 31st! Thank God for this tool and allowing for this process to be hassle free.

Just got approved by Blue Cross California HMO...ppwk was submitted on Friday June 29th and because of the long 4th of July weekend, I was notified on July 6th that I was approved on the first letter!...so after everything was faxed to my surgeon...my date is Aug 14 2007...I'm in awe...I started this journey only 3 months ago...amazing! BMI 45.3 NO co-morbidities Dr. Philip Quilici

I was approved by Tricare on 07/06/07. They approved me the same day that they recieved my paperwork.

YIPPEE!!!!!!!!!!!!!!!!!!!!!!!!!!!  Insurance received my paperwork on Tues 6-26-07 and I was approved on Tues, 7-3-07.  !!!!!!!!!!!  Received my letter in the Mail today as well as a phone call from the surgeons office today to schedule my first visit!!  Wow!!  This was so easy!!  I can't beleive it!.  I was expect major hurdles!  BC/BC of Nebraska, State employee's plan!  I guess I can say that this is the first time in my life where my weight has helped me get approved!.    I was not required to do a supervised diet, (which I expected they'd come back with), or have a  documented weight loss history!.  I have none documented! My PCP never documented anything we talked about when I went in for anything.  So guess I dodged those hurdles.  I'm so happy, but at the same time apprehensive about the major life change that will be happening!  I'm SO prepared for it!  .  I'm so ready for this journey!!  Anyone please share some thoughts or ideas with me!!!!  Looks like Surgery will be happening in Early October.  

Approved in less than 24 hours.   Had all of my information ready so that all the insurance clerk had to do was submit it .    She was WONDERFUL!     It pays to have someone *****ally knows their stuff.  By the way,  I have BC of AL.

tried to move this post.  best i can do, and congrats Post Date: 7/13/07 7:51 pm I just want to let everyone know that if your policy has an exclusion on wls you do have hope.  It took me a year, two appeals, a grievance hearing, but I WON!  I just got my approval letter yesterday!  I feel as if I won the lottery!  I have read and researched ant fought and prayed, and it finally happened.  I know that if it can happen to me that it can happen to you, so dont give up!  What is even better is that I did this all on my own, no attorney, sorry Gary, but it has really boosted my confidence level. Good luck to all. Rebecca.

My insurer is Premera Blue Cross Blue Shield Alaska Care,  PPO. My plan has some interesting language, not the same at the Aetna qualifications I've seen: "Gastric bypass surgery and vertical banded gastroplasty surgery are considered medically necessary and appropriate when the following criteria are met: the patient is twice or 100 pounds over ideal body weight, as determined by the claims administrator; there is a documented history of recent (past 6 to 12 months) attempts to lose weight through physician-supervised, nonsurgical means; and there are no contraindication to surgery. Noncovered services include, but are not limited to, intestinal bypass surgery, loop gastric bypass, gastroplasty (stomach stapling), duodenal switch operation, biliopancreatic bypass, mini-gastric bypass, gastric bubble balloon surgery, special diet supplements . . . " So I was concerned about several issues: Would I qualify? I am 5'9", 252 pounds, so if my ideal body weight is BMI 22 (149 lbs) then I am 103 pounds overweight (Whew!!!  good think that Weigh****chers weight came back)? Would the vertical Sleeve Gastrectomy be covered? Yes, apparently.  I don't have any co-morbidities. I started the dr. supervised diet in May, but if they needed 6 months, it would take till October.  I did have 18 months of weigh****cher records, but don't even know if those got sent to the insurance co. So after dogging LapSF, and checking with my insurance (request for approval faxed by LapSF on July 3, and July 13, never rec'd by insurance, LapSF refaxed and called insurance on 7/15). I can't believe it. I  called the insurance company this morning, 7/19, just to see if my request for authorization had been received, and customer service confirmed that the request from LapSF was being reviewed.  A couple of hours later I checked my email  and saw that there was a message from Marilyn at LapSF. It said " I have obtained the authorization.  Now to place you onto the schedule, you need to pay the non covered service fee of $5500.00    Once this is secured, we can place you onto the schedule." 5 magic words!!!!  "I have obtained the authorization" I had to call immediately and make sure that it means that my insurance will cover the VSG.  They said yes!!!   Holey Moley.

I just can't really take it in.  This could happen soon!  I don't have to wait until October!  Yeah!!!!!!!!!! I still can't believe it . . . . . . . .