Needing Info for First Step

I live in Dedham, and have Blue Cross - HMO. My BMI is 48. I just switched pcp's, so I have to set up the initial appt. with her. How should I approach her about it? Are pcp's usally hard to get on board with the lap-band surgery? If I can get the referral from her, what do I do next?? Is MGH a good hospital to have it done at? Do I go and have a consoltation with the hospital/surgeon before I submit any paperwork to the insurance company.. will they help me with that? Thank You so much for any help you can give me..... Erin Dedham MA

HI, I also have BCBS HMO. My surgery is scheduled on May 31st at Beth Israel.I wrote everything down when I went to my pcp; my weight, height, BMI,comorbids, diets I've tried. I told him I had done alot of research about wls and that I qualify and I would like a referral to talk to a surgeon. He hesitated a little and said he'd really like me to try weigh****chers one more time and I said "Look, I am cutting 15 years off my life being obese, I want to start the surgery referral now, not after one more diet failure". He said OK and referred me to Beth Israel. Once I got referred and saw everyone at Beth Israel, they decided I was a good candidate. They took care of the insurance approval for me. I didn't have to do a thing. I'm now one week away. By the way, I'm considered a "lightweight" with a BMI of 40; try carrying an extra 100 pounds around on a 5'1" frame. I also have high blood pressure, GERD and arthritis. Good luck Paula

Hi Erin, I also have BCBS HMO Blue, My PCP thought it was a great idea when I approched him about it. I think alot of that had to do with my other medical problems and my Ortho surgeon had recomended it too. I also need total knee replacements and have arthritis, gerd and major back problems. The only program my pcp would refer me to is the one at the new england medical centerin boston. It took awhile to get my 1st appt. but once I did, the ball rolled pretty fast and they take care of all the getting approval and dealing with the ins co. They also have a wonderful program that pre and post surgery. good luck to you! (o: Trish

Hi Erin - I also have Blue Cross HMO Blue and found the process very easy. My PCP had recently left the practice and I found a new one who specialized in obesity and diabetes. I felt this was a good match since I had been diagnosed with Type 2 diabetes 4 years earlier. My BMI was 43. I had lap band surgery at Emerson Hospital on January 25th and have lost 43 lbs (30 lbs post surgery). The pre op testing and meetings only took 2 months and then 2 days to approve by Blue Cross. I would highly recommend the program. It is fairly new, but with very experienced doctors. The hospitals complete all the necessary documentation to submit to the insurance company. Most programs require blood work, EKG, sometimes sleep studies, etc., as well as a psych eval and meeting with a nutritionist from the program. Best of luck Leslie 250/207/150ish