2009 bcbs federal is there a Prior 6 month diet supervised by physician requirement?

  Anyone out there this year 2009 trying to get approval from bcbs federal standard on revision from lap band to RNY?   I heard that there is a prior to surgery 6 month diet supervised by physician requirement?  I had the lap band done in April 08 and only lost 16 lbs then gained 13 lbs.  I'm not sure if they will accept that as the 6 month diet.  I have co morbid illnesses, Type II diabetes, high blood pressure, high cholesterol and high risk of stroke and heart attack in my family history.   I know last year the requirements for lap band was to have BMI of 40 or 35 with co morbid illness, diabetes, high blood pressure, high cholesterol.  Now, hopefully in February or March I am planning to get a RNY as my revision.  Anyone out there going through this? Pease share your thoughts and experience.

Thanks       

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Hi Alabama,

What's going on with you?  I'm still waiting to get an answer from the doctor's office .  Did your doctor tell you that you must be on a 6 month diet prior to surgery?  Do you have BCBS Federal  PPO?  

Thanks for replying.  

No, the 2009 brochure doesnt say anything about a 6 month diet. It didnt in 2008 either. I had my revision in 2008 with BCBS FEP basic. Here is a link to the brochure. Scroll down to page 52.


http://www.fepblue.org/benefitplans/2009-sbp/SBP2009Brochure _English.pdf

Hi Fortworthgal,

Thanks for replying.... I went to the website you gave me, I have that same one my favorites.  I called the dr. office and spoke to lady who handles insurance paper work, Jinny.  I told her that I called BCBS Federal and spoke to 3 different people and they all said there is no 6 month diet requirement.  They said that might be BCBS State or regular insurance but not for Federal PPO insurance.  Jinny said, those people do not know what they are talking about. .  She said,  I have it in writing, it states you must be on a 6 month diet prior to surgery or BCBS Federal will not pay.   She said she had another patient get denied by BCBS Federal because they do not cover Revisions.  I know that's not true because I called BCBS Federal before I decided to get the revision done in the first place, and they said they do cover Revisions.  HELLO???  

 I 'm not sure what stage my process is right now.  Yesterday  the dr. office called me the nurse  left a message on my cell phone wanting to know my weight before I had the lap band.   How much was the most weight I lost with the band and if I had any adverse events happen to me.  I called her back and left a message on her voice mail.  We were under a State of Emergency yesterday and today due to the very cold ice storm we have here in Oklahoma, so the dr. office is closed.  I guess I will here from them later.  I hope this gets straightened out.   I'm so tired of all this bull corn!!!   
 
 Anyway, you seem to be doing great with your RYN!!!  Keep up the great work.......

I hope to do as great as you.      Thanks for reading my message and all your help!!! 

   Talk to you later Fortworthgal.