Approved for VSG!

I've spent a lot of time on this forum, looking through posts to find out which insurance co's were approving the VSG.  So I thought I would post on here that I did get my approval today from BC/BS of GA for a VSG, and am scheduled for July 7th!!  I have a BMI of about 42, am generally healthy but am showing signs of possible future complications from my obesity (currently age 31) , and was approved w/no appeal needed.  I thought there used to be a thread for posting if you were approved, but I can't find it now.  Just know there is hope for getting the VSG paid for.  Everyone in this industry kept telling me it couldn't be done, but I knew from all the wonderful people on OH that it was possible!!    *Angel

Congrats!! My insurance (bcbs of Nd) wont cover the procedure yet..So I have decided on RNY..but VSG would have been my first choice.

Thanks Andrea.  Are you from ND?  That's where I'm from originally...in fact I'll be going up there this coming week to visit family for a few days.  When are you looking at having your surgery?

Yeah I've lived in ND my whole life.  I want to have surgery as soon as I meet the Dr.s requirements.  I have to attend a imformational session, then I have a physical and psych eval..Im hoping my insurance approves me easily..we shall see.  What part of ND are you from?

Thanks for posting this. It helps to know that there is HOPE for approval, esp. when we all hear so much that it's not being approved yet.  THANK YOU- THANK YOU- THANK YOU!

I just heard from BC/BS Anthem (CA) that they won't cover VSG because it's considered experimental.  Do you know what coding your provider used to request? 

I really want VSG, don't want to consider any other types, I think it fits me best.  Any ideas for insurance?

Did you apply and were denied or did you just call to see if they cover it?  Honestly, my insurance sounds like they won't cover it if I look at their list of criteria, but when we submitted it they approved it.  And I know it's being paid because I got an explaination of benes from them already. 

If you were denied, you can appeal.  I would look on here & on the VSG site for info on what to use in your appeal.  I would also mention which companies are covering it, like BC of Ga, MI, Fed BC/BS, etc.  I think there are also some good copies of appeal letters that lead to approvals on here.

If they just told you they don't cover, then you have to submit & see.  I know my surgeon just used the code everyone on here uses for VSG.  (I know it's something like 48343 or something similar...that's probably not it but I can't remember off the top of my head)  Sorry I can't be more helpful.  I wish you lots of luck...let me know if I can do anything.

*Angel

I actually applied, the surgeon's office sent in the precert information and they called and told the insurance coordinator the don't cover the VSG.  When I called the next day to see if I could bet more information I was told it was still with the review department.  So, no formal denial letter yet but the surgeon's office felt it should be here in a few days. 

Thanks for your information and encouragement.  I just know that VSG is the best choice for me.
BreezinJ