(Hi!) Newbie with BCBS MI

Hi Everyone,
I am Nichole and I am ready to start my WLS journey! This website has already helped quite a bit. But of course like all newbies I have questions. I received my insurance criteria sheet with the following that needs to be done: But seriously is this it and then “magically" I am approved? So what's the catch?

The Patient has a body mass index greater than 40 or greater than 35 with co-morbid conditions. (Check)

The patient is between 18-60 years old. (Check)

A physician has documented failed medical management including a structured professionally or physician-supervised weight-loss program for a minimum of 6 consecutive months within the last 4 years. (Started 02/12/09)

There is documentation that the primary care physician and the patient have a good understanding of the risks involved and reasonable expectations that the patient will be compliant with all post-surgical requirements. (I am pretty sure I will be a good girl)

A contracted mental health professional has preformed a psychological evaluation to establish the patient emotional stability and ability to comply with post-surgical limitations. (Scheduled for 02/23/09).   Surgeon Consultation is scheduled for 04/14/09 with J. Hunter in FedWay. Anyone else have him? I am hoping that my Weigh Watchers receipts will suffice the 6 month professionally monitored diet.

Hi Nichole!
Welcome to the group! I'm glad you have already done some research and are posting to get some questions answered! Dr. Hunter did my surgery as well and I have really enjoyed him. I don't have BCBS but my insurance did require that I jump through hoops to get approved.... and once I did, it was like "magic" as you put it! Feel free to check out my blog and ask questions anytime.

Thats what I had to do... and I got approved...  well except for the psych eval... I did not have to do that.

Re: weigh****chers.. you should check with your insurance.... most insurances will not accept WW as a medically supervised 6 month diet.  I went to a dietition... and some of my friends have seen their PCP once a month for 6 months.

I love Dr Hunter .. he was my surgeon... and he also has great bedside manor.  My husband who was a wreck on the day of my surgery was really impressed with Dr Hunter. We must have been laughing about something when Dr Hunter came in to see me in my hospital room before he left the hospital on my surgery day... since he asked us if we were having a party in here... we told him yes! And he laughed!

There are several people here who have had Dr Hunter.

The Support group for Federal Way is on the 4th Weds of the month in the lobby of the ASC. I usually go.

If you have any questions about Dr Hunter or Virginia Mason.... PM me..

Helen

Thanks girls for the welcome. I am very excited. So how did you both hear about Dr. Hunter? What made you choose him?

Welcome to OH , Nichole .