farmer2120000

your pcp can put in in their notes that your excerise routines were not working for a year. i was approved for surgery by bcbs in less than 4hrs once paperwork was sent in..... banded oct 11 2011

nacol your pcp can provide that info i brought an elliptical worked out lbs were not coming off she asked what kinda work our rotuine i followed i told her what i did she documented it.

I was thinking the same after doing more research on vsg vs the band and what i understand the vsg is a two part surgery with the second being swiched to a gastric like bypass procedure. i read they are trying to see if the vsg can be stand alone procedure. i am currently banded and i've lost 31lbs in a month the lap band works I was home after the surgery in an 1hr and was'nt in a whole lot of pain after my surgery mainley i was sore but hey whichever surgery you chose is a personal choice good luck to you

I have fed BcBs basic i will review my statements as they are just now rolling in i was banded oct 11th 2011 now im in a different situation i had me the $5000 co pay cap so the surgery was covered 100% what i did is call the 800 on the back of the card and have the customer svc rep verfiy everything with care mgnt....the customer svc reps read a script where care mgnt reps actually deal with the processing of the claims but just from what i know it is if the surgery is preformed out paitent cost are $150 per surgeon x2 now the band itself is considered durable medical equiment which you have to pay 30% if preformed inpaitent bcbs will cover 100% of the band any medical supplys used including anethesia you have to pay 30% if inpatitent they cover 100%

We seem to all have different post instructions for the life of me i dont know why... I was able to shift to full liquids and protein shakes after three days...i would call dr office an ask i just had my 3 wk post op check up yesterday doc says he's happy with my progess...

I was Banded 11th Oct today marks the start of week 3 for me doc says i have one more week to go before i can move into solids woo hoo. The hunger pains do suck matter of fact it sucks so bad i get woken up out my sleep. what's been my motvation my fat clothes are loser on me and when i get on the scale the lbs are going down 27lbs since being banded....i know it sucks stick with it good luck

It's weird we all have different post op instructions i was banded a wk ago today and I was allowed full liquids on day 3....sat was my 1st ok day without having hunger pain all day

I don't remember a thing i was knocked out before i made it to the OR i woke up ALL done .....i'm surprised how it was'nt painful at all...

wow i was 305 prior to surgery i was just banded tues the doc said i carried a lot of my fat in my gut ...when i went for my final consult 1 wk prior to surgey i asked if i need to swich to a special diet he said no lose what i could but he felt i'd be okay surgery went well...gl to you

i totally understand i was banded tues and i sucks having only clear liquids

what ins co do you have?

in my dealing with feb bcbs the personnel who are in the know is care mgmt..when you call customer service with questions ask them to confrim with care mgmt since they do the approvals i just got banded less than 12hrs ago....so lets say in you went the dr for whatever in dec 2009 you were 250lb and and oct 2010 you went and 255lb that would be acceptable to meet the requirements because care managemt would know based of the bmi scale you were 40% or more....hopes this helps once my packet was submitted took less than 24hrs to approve..gl to you

1st thing 1st are you basic or standard ? and are you fed bcbs..... call bcbs and ask rep to confrim info with care mgmt....care mgmt deals with the clams the reps read the benfits brochure like we do and and its not 5 yrs it 2yrs and it doesnt have to be contious 2yrs just got banded yeasterday i have feb bcbs basic.

Here are some things to keep in mind about surgery for morbid obesity: • Prior approval is required for outpatient surgery for morbid obesity. For more information about prior approval, please refer to page 17. • Benefits for the surgical treatment of morbid obesity, performed on an inpatient or outpatient basis, are subject to the following pre-surgical requirements: − Diagnosis of morbid obesity (as defined on page 52) for a period of 2 years prior to surgery − Participation in a medically supervised weight loss program, including nutritional counseling, for at least 3 months prior to the date of surgery. (Note: Benefits are not available for commercial weight loss programs; see page 34 for our coverage of nutritional counseling services.) − Pre-operative nutritional assessment and nutritional counseling about pre- and post-operative nutrition, eating, and exercise − Evidence that attempts at weight loss in the 1 year period prior to surgery have been ineffective − Psychological assessment of the member’s ability to understand and adhere to the pre- and post-operative program, performed by a psychiatrist, clinical psychologist, psychiatric social worker, or psychiatric nurse (see page 85 for our payment levels for mental health services) − Patient has not smoked in the 6 months prior to surgery − Patient has not been treated for substance abuse for 1 year prior to surgery • Benefits for subsequent surgery for morbid obesity, performed on an inpatient or outpatient basis, are subject to the following additional pre-surgical requirements: − All criteria listed above for the initial procedure must be met again − Previous surgery for morbid obesity was at least 2 years prior to repeat procedure − Weight loss from the initial procedure was less than 50% of the member’s excess body weight at the time of the initial procedure − Member complied with previously prescribed post­operative nutrition and exercise program • Claims for the surgical treatment of morbid obesity must include documentation from the patient’s provider(s) that all pre-surgical requirements have been met

i have federal bcbs and i was approved in less than 24hrs im schduled for surgery on 11th

If you can have it done in-patient fed bcbs covers more that way since your not at your cap yet out patient you will be responsilbe for 30% of the band it self which can be upwards of $2000 on our end 70/30 split which i believe is the most expensive part of the surgery i read the benfits brochure 20x's lol just to be sure and i haveing my pre surgery appt tommorw afternoon wed is my pre admit with hospital and the following tues the 11th im schduled for surgery i have a child who has stuff done that chews up my out of pocket co pays pretty quickly

Just follow the guidelines to the tee and you will be fine i have bcbs fed basic and i was approved in less than 24hrs by care mgnt my surgey date on oct 11th

i have basic i called care mgnt they said due my reaching my out of pocket max my co pays would be 0 for everything

i saw something some where $2,200 for the band im curious as we i've met the max for co pays as well ...

best place to start is call bcbs directly they are very helpful i got approval for surgery in 1 day