I am giving up

I appreciate everyones encouraging words about my dealings with Dr Bauman, but I think it is a lost cause. I would really like to have this surgery, but because I rarely get sick I don't have the medically documented weights that BCBS requires. I don't know what else to do, besides give up.

Thats exactly what the insurance company wants you to do............GIVE UP!!!!! then they don't have to pay. Keep fighting for what you believe in and for what you want. So many times we have given up don't let this be another time. Your health is worth it. And if you feel strongly about this surgery fight for what you believe in. Good luck in your journey . -113 lbs and counting

I agree that this is just the insurance comanies attempt to stonewall you and get you to give up. For many/most insurance companies this is their standard practice. DONT GIVE UP!!! I started this "journey" 2 years ago really and have (seriously) been trying to get insurance approval for about 8 months now. If documented weight is your only problem you are better off than I was 8 months ago. If you for instance need a three year weight history there are more than a few ways (wink wink) to get that information.

Brian I hate to be the naysayer on this post, but if following a doctor's supervised diet for six months is that big of a problem for you, then maybe WLS is not the answer for you. This is not something that you just casually decide, "Oh, I think I'll do this today." This is a permanent situation. Also, if you don't follow the instructions after surgery you can regain all of your weight and more. You don't have to be sick to go to the doctor. Let your PCP know up front why you are there. He/She will put you on a diet plan and weigh you monthly. Then in six months you will have all the documentation you need for BCBS. Ask yourself, "Where will I be in six months if I do nothing?" Larry

I woud like to thank everyone for thier encouraging words. I got a reply back from Kim at DR Bauman's office with some encouraging info. And as for you Larry, I may not have been perfectly clear in what I wrote or either you misunderstood what I was writing. My insurance does not require a 6 month weight loss program. If it did I would have no problem with doing that. That is not the problem that I am having. They require that I have my weight documented by a medical professional for 5 consecutive years, which I do not have because I don't go to the dr very often. I can assure you that this is not a decision that I have in any way taken lightly. I have researched this extensivly for over a year before even calling DR Bauman's office. I like most people here have had little or no long term sucess with diets. So please be sure that you are certian of what you are reading before you post such negative comments. Brian

Brian Please forgive me for not understanding what you wrote. It is never my intention to be such a negative person (even though I did preface my reply with being the negative naysayer). Your post just hit a nerve with me that made me get defensive and again I apologize. I and many others (from the men's board) had major complications and would go through the personal hell again to have the great results that we have had from this surgery. I just interpreted your post as just giving up without a fight and I just couldn't believe it. This surgery is so important to us that have been and/or are morbidly obese. It would be my desire that every insurance company in the US would loosen their dietary restrictions and go on the PCP and Surgeons referral for surgery. After all, what other surgery is questioned (other than plastic surgery) when requested by a surgeon? Didn't the surgeon go to medical school to help mankind and improve our quality of life? Surely he or she has enough medical knowledge to know if we need the surgery or not. Again, I apologize if I came across too harsh, but that was not my intent. Good luck on your journey and if I can be of any personal help please just email me and I'll do whatever I can to help. Larry

I didnt meet BCBS criteria for WLS but I got approved after going thru their appeals process... dont give up and still go forward!!

I wouldn't give up yet...I am glad you got some encouragment today. In my experince with BCBS they will take weigh****chers or something like that for weights. Also get your PCP to write a letter..it has helped in the past. Even if you are denied APPEAL!!!!! I have personally known 3 people appeal BCBS and won. So hang in there.

Hi Brian, Don't give up! Nothing worth while ever came easy! Don't you get sick of hearing that? :lol: I know its hard. I have just made the decision to strongly pursue some type of bariatric surgery. I also have BCBS NC and I have not been able to find any info on what documentation they may need. But I decided to go ahead and call and make an appointment with Dr. M's office and hope for the best. But when they questioned me and asked if I smoked, I said yes. They said they would not do the surgery unless I had stopped smoking for 3 months. I knew I had to quit before surg but did not realize I had to quit that far in advance. :shrug: So today is day one of my smoke free life! :thumbsup: I am going to start having documentation of any and everything I can think of between now and then! But I think there is some loop hole you may find. Does your doctors office not have any suggestions? I would think they had seen it all....

Hi Monica- I just read your post and wanted to tell you that if you call BCBS and ask them for their 'coverage position' they might be able to give you exactly what you are looking for. I called my ins ****igna) and they directed me to it online and it was called a 'coverage position'. It spells out exactly what I have to have, and you can believe I am gathering it all, exactly as they want it! GOOD LUCK! Stefanie