NEW HERE...BCBS insurance. Anyone know the process for revision?

Hello...I am new here.

I am in the very beginning stages of deciding on a band to bypass revision. I was banded in August of 2009. Took me 2 years to lose 65ish pounds. I then got pregnant with my third child and, well, all hell broke loose. I gained most of it back. I am just so tired of the fills, unfills, food getting stuck, pain after one bite, sliming, etc...etc...

My doctor says that a bypass is the best procedure because of scar tissue. I am very scared, but I know I need it. 

I feel like I try very hard and lose 20, then gain it back. It's a constant battle!!!

Anyway...I am waiting for the girl to call me back from the office, but has anyone been approved quickly for surgery. I am a teacher and I am hoping to have surgery in August. Does anyone know what the process is for BCBS PPO out of PA?

Do I have to go through the long 6 months like I did with the band or will they approve with less requirements because it's a revision? I think with the band I had to do 6 months of visits, see nutritionist, psych doc, go to a support meeting, etc. 

Hi Jo....another Jo here :)

I too am in the beginning stages of getting a revision from a lapband to Vertical Sleeve.  I JUST got off the phone with BCBS to ask if I really had to see a nutritionist for 4 visits (90 days) since this is a revision. In fact, my diet is fine...its the band that keeps me from eating it...mostly random tightening.  I'm grateful for what the band has done for me, considering all the comorbidities I used to have but.....just got stuck one too many times...living this way is NOT acceptable! 

Anyway, BCBS said I needed to get my doctors's office to call BCBS Case Management and they could possibly waive that requirement since it is a revision.  So, I figure I will go about getting all the other things on the dr's list checked off  and then ask the dr to call Case Mananagement for me.  I dont have to go to support groups or have 6 months of weighins at least

So, take a deep breath. Don't be scared....you've been through this before, right?  This probably won't happen very quickly but if you stay on it, within 3-6 months. I have BCBS Federal so my requirements could vary from yours.  I HAVE to get it done before January so my deductibles won't start over at zero.

Good luck

Jo

When it comes to insurance you need to get a copy of your own policy.  Two people can both have BCBC PPO out of PA but their employers may have different requirements.  While my daughters BCBS didn't require a supervised diet for her BMI, her employer required a 3 month.

For my revision I was required to do everything again PLUS my surgery center required an additional 6 sessions of counseling and all the stupid Nutrition classes.  After I made it thru in three months they changed it to 6 months of therapy.  It took the next poor lady that had the same issues as me a year to get the revision.  The person right behind me got surgery first as I had HMO and she had BCBS.

You'll have to check your policy. I have BCBS and had to have a behavior evaluation, nutrition assessment, upper gi, and a written justifications written by both my surgeon and myself. 

I'm BCBS PPO IL and I was approved for revision without having to do any psych or prep classes. I've been told that my employer has the best coverage so it really does depend on the employer group coverage....