Just starting out

Hi, everyone.   I have had my consultant with the lap-band surgeon and just got a letter from them today.   They said before they even apply to my insurance company (Preferred Plan, Inc. administered by Wausau Benefits) there is a laundry list of things I need to do.      The six month CONSECUTIVE MONTHS of physician-supervised diet  psychological evaluation nutrional evaluation by registered dietician my last two years of medical records a thyroid panel and TSH (????) test proof (through my medical records) that I have been at or above a BMI of 35 for over two years - this is my biggest concern.    I have NOT but I fear if I have to wait until I have been at +35 BMI,   I will end up being at a BMI or 40 or 45!   My surgeon's office won't even request the approval from my insurance company without me doing and getting the above info.   Any suggestions, especially on the BMI of +35 for more than two years????

That's pretty much standard for many insurance companies now.  I finished my supervised diet on the last of July and finished all other testing at the end of August, submitted on Sept. 1st and got approved on Sept. 12.  They know what the requirements of your insurance company...that's why they won't submit until you have done what the insurance company requires.  If they do it any sooner, you will be denied ..and some insurance companies have a limit on how many times you can appeal the decision.  It really does you no good to submit when you know you can't possibly be approved.  If I were you I would get a copy of your insurance companies policy on obesity surgery and make sure you follow their requirements to the T.  It pays you to be educated on what you have to do, not just rely on the surgeon's office to tell you.  You have more at stake than anyone if you get denied.

Good luck,