TraciLJ

Well, they denied me with the investigation/experimental excuse. Also said that the medical research doesn't prove it's better than the bypass. Screw them! On to the appeal process. My doctor's office is enlisting the assistance of a US Senator's office in MN that helps people fight their insurance company. They're quite interested in these appeals. --TJ

Thanks Anne and Alexandra! I know I need to be patient, but at times it's just so hard.

Well, I have BCBS of MN, and as most of us know they've put the band on an experimental/investigative status. They aren't denying all claims, but are reviewing on a case-by-case basis. My paperwork was submitted last Tuesday, and I called for a status update today and was told it was still in review with the medical review board. I'm more than anxious and am wondering if the fact that they're taking longer is a good thing or a bad thing. The other folks I've talked to that were approved prior to the BCBS change of mind were approved in less than a week. Thanks for listening!

Thanks for sharing your experience! I'm glad to hear all is going so well for you. Hope to join you in Bandlandia soon!

I've heard that BCBS of MN may be changing their minds, again, regarding the LAP-BAND. Talked to the coordinator in Deer River today and she heard from the Crosby coordinator that BCBS may lift the investigational/experimental status from the band and start covering it again. Yahoo! I sure hope this is true as my paperwork will be submitted within the next couple of days.

Hey Misty! I've heard that Dr. Billing charges $11,000 for those who self-pay for the LAP-BAND. This was from someone who talked to him about it within the last week, so I'm assuming it's an accurate quote. If you're interested, you can contact his coordinator in Moose Lake, Delores, at 218-485-5892.

Grant: Maybe try contacting someone at INAMED. I know they're helping my doctor's office out with requests that are being denied on that basis. Good luck!

Billie: I just called my docs office to check to see if the psyc eval got there yet. (it hasn't) Anyway, the coordinator wanted me to know that they recently received a denial from BCBS of MN for the reason that they now consider the LAP-BAND experiemental. The office has enlisted the assistance of INAMED in the appeal. You may want to check with your doctor's office to see if they're doing the same. And, if they're not, ask that they do.

Gabby: Congrats on getting your band and starting your "band" new life! I'm hoping to have my surgery by mid-February if all goes well. Keep us posted on your progress!

Thanks for your responses! I was just "psyc-ing" myself out, so to speak. Bob, I hope you get good news about your approval soon!

I had my psyc eval today. It was exhausting, but I'm glad I did it. Anyway, the psychologist said my tests indicate that have a high tendency towards problematic compliance. Which basically means that consciously I have every intention of following the after-care regimen, but my sub-conscious kind of takes over and knocks me off the wagon. An additional component of this is that I let the "world" think I'm doing ok. She said that wasn't a problem as long as I would agree to see a therapist for the first six months to help me through the rough spots and as another source of support. Of course I agreed to do so...whatever it takes to be successful at this! She is going to write her evaluation "approving" me for the band provided I get the proper after care. What, if any, problems can I expect with my insurance company? Thanks!

Tackleberry: Thanks so much for sharing your experience. I was hoping that the band would cure (I wasn't sure that was the right word to use) the symptoms of GERD. So you don't have to take any Nexium/Prevacid type pills anymore? I'm really hoping that the GERD is what is causing the esophagus problems I'm having, as it will help make the case to my insurance company.