Taking my first step today need advice

Betty S.
on 1/9/09 12:46 am - Mesa, AZ
Hi all;  I am going to my PCP today to begin the appointments that BCBS of AZ are going to want in the precertification process.  I Have a BMI of 44,  had self pay band surgery in 2005, had to have it removed in 2005 because my body seemed to reject it.   I do have Barretts esophagus, and Tuesday am going to have my annual biopsies, where I'm going to ask my GI doc if I might be a candidate for the sleeve surgery. 
From what I read here, people with BCBS need to have 6 months of DR supervised weight loss, so today I'm going to ask him to start 'supervising' me. 
I'm operating in the dark because my company just switched insurance carriers, and I haven't been able to get the information from BCBS yet. 
Any advice for what I should ask for today would be greatly appreciated...
betty
(deactivated member)
on 1/10/09 4:53 am - Woodbridge, VA
Your HR department should be able to provide with a written copy of your policy. Make sure they have not excluded the WLS rider on your policy.
T S.
on 1/10/09 9:38 am
I started a weight loss program with my PCP and when I met with the weight loss surgeon for the first time, they said being on a supervised program with their nutritionist is better for insurance approval. I wasted two months of time and money because the surgeon had different requirements. If you know who you want to have for a surgeon go to them first to see their requirements. I too am in the hole between policies and have no information - sooo frustrating! Hope this helps.
Jackie R.
on 1/11/09 11:09 am - Baltimore, MD
call the insurance company and verify you have a benefits for the sleeve, some insurance companies say it is still experimental, and will not  cover it so ask specifically if that surgery is a covered benefit.
I can give you the criteria that the inusrance company uses for bariatric surgery so you will know you got it all covered. you need 6 monthes of supervised diet attempts which can also be like wiegh****chers' nutrisystem ect.
Hope that helps I m a ur nurse I do the reviews for an insurance company for medical necessity of  hosptial stays and have reviewed alot of wls cases.


pre op diet wt 293
    
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