Melissa S

TheLid... I'm waiting right along side of you on this one.... I have Empire BCBS of DE which only says the patient must have actively participated in non surgical methods of weight loss... here is the link: http://www.empireblue.com/provider/noapplication/f2/s5/t9/pw_ad080419.pdf The surgical coordinator told me it was to be a 6 month medically supervised diet..but that link comes directly from BCBS (sent to me by the customer service dept)... My info was submitted to insurance Thursday... they sent medical records, a letter from my primary stating she is aware of my weight loss attempts as well as emails to and from her regarding diet, exercise and request for labwork... I also submit a payment record from the past year and a half of gym membership... hopefully that'll do.

OMG Amy... YES!!!!! I had that same issue this past weekend!!!

My daughter, Jordan was a challenge... I think she was 3 or 4 when she got the hang of it all.. she was extremely hard to potty train with the poop too! She was always too "busy" to come in. There was this one 4th of July weekend when the whole family was down at my grandparents beach house.. I'm talkin like 20 people... and Jordan wanted to hang with the big kids.. they played all day.. and she never wanted to come in to use the bathroom... so I had plenty of sh*t stained underwear that I had to throw out... I mean.. a couple pairs had a full fledged turd in them. How she could run around with that in there... I have no idea..and the best part.. you'd ask her if she pooped in her pants and she'd say no...while reaking of sh*t, mind you....

Since my surgeon only requires a pre op diet of clear liquids for 24 hours prior to surgery... I took it upon myself to replace 2 meals per day with protein shakes, and eat 1 low fat, low cal meal.... I'M GETTING HUNGRY!!! GRRR! I'm still waiting to hear about the insurance. I spoke with the scheduler from the surgeon's office today... she said she faxed everything to them on Thursday..and should hear something very soon..maybe even today. I'm very nervous.

Since my surgeon only requires a pre op diet of clear liquids for 24 hours prior to surgery... I took it upon myself to replace 2 meals per day with protein shakes, and eat 1 low fat, low cal meal.... I'M GETTING HUNGRY!!! GRRR! I'm still waiting to hear about the insurance. I spoke with the scheduler from the surgeon's office today... she said she faxed everything to them on Thursday..and should hear something very soon..maybe even today. I'm very nervous.

Amyc... My surgeon has a min BMI of 35..and thats only if you have other weight related health issues (High BP, Cardiovascular issues, arthritis). Otherwise BMI must be 40 or higher.

Yasmina... I use unjury... I've compared it to my fiance's protein powder (which is super high in fat, calories and cholesterol) and the unjury has only 90 calories, 0 fat and 3g of carbs and 0 cholesterol per scoop. I use the vanilla quite a bit (blend in fresh fruit...and my latest find..cinnamon and pure vanilla extract to make it taste like a cinnamon bun)...it does have a slight "protein after taste" but its not bad at all.

WOOO HOOO!!!! I'm excited for you! I'm still waiting to hear back from insurance... I was told they may hear something today...

I just spoke with the surgical coordinator/insurance rep...she told me she faxed all the info to BCBS on Thursday and may hear something back today!! Keep your fingers crossed!!!!

Surgery is scheduled 2 weeks from today... I made a call into the surgeon's office, left a message to see if they have heard anything from my insurance company... keep your fingers crossed. I took it upon myself to start a pre-op diet today... since my Dr only requires clear liquids 24 hours before... I'm doing 2 protein shakes per day and 1 light meal (most likely salad w/ chicken) .... lets see how it goes. I'm so glad there are SO many supportive people here...who are all in the same situation.

19. not be ashamed to be in a FULL LENGTH picture!

Empire BCBS of DE actually states in the coverage description that the BMI must be 40 but no higher than 50... of course 35 or so for those who have other weight related issues (Cardiovascular, high BP, severe arthritis...) .... and that is applied to all weight loss surgeries. So, Chef.... you had a similar issue as I do, and you were quickly approved?

My primary has monitored my BP very closely for the past 8 months or so... and she knows I have followed a diet and exercise routine... I have since dropped my BP from 192/98 to 122/83...with no meds.

Thank you for the Calendar!! I don't know about the rest of the May Bandsters.... but seeing everything written out on the Calendar makes it seem more real!!!

I've done: Phen/Fen...3x L.A Weightloss Adkins... 3x South Beach Grapefruit ...not to mention the low fat low cal on going diet I've been on and off for the past 20 years....

Twimmommy... AMEN! to add to the list: *be able to cross my legs *be able to pass by someone and not feel like my huge @ss is gonna knock them over *wear "cute" undies again... shop at Victoria's Secret again! .... I'm sure I'll think of more.... ...Speaking of Lane Bryant... which, I love and I'm sure has provided all of us stylish, nice clothing.... I passed by the Lane Bryant in our local mall..and there was a sign outside saying "Ranked number one in sales for the year 2006"..which, if you think about it... its kinda sad.

Thank you Jill... You're list of documentation is a lot like what has been sent to my BCBS. I've been extremely busy this weekend so I really didn't have time to think about the approval.... but of course, I'll call the surgeon's office first thing in the morning!

right. My fiance keeps telling me... I'm sure you'll get approved with no problem... I have my doubts though...and I hate to think that way. Like you, I'm just tired of the up and down..the disappointments and struggles. I'm a Libra and we're supposed to be laid back..?!?!?! Not THIS Libra! HAHA!!!

Empire BC/BS of Delaware

Is it just me...or has everyone at some point been scared sh*tless that their insurance would deny their surgery?!?! Ok, heres my issue... I have my own "version" of a medically supervised weight loss attempt...the scheduling coordinator/insurance lady-person (not really sure of her official title) was on the phone yesterday with BCBS for my pre auth and was unable to meet with me... I was there dropping off supporting info that they may need to submit for my approval (emails to and from my primary regarding weight loss/exercise/lab requests from 8/06- present and proof of gym membership/payment from 8/05), my primary also sent a letter stating she is aware of my weight loss attempt(s). I've read Empire BCBS policy on weight loss surgery...and it does not say specifically they need 6 month medically supervised diet (as the coordinator told me)... only "patient must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for the surgery" I'm just afraid because I did not participate in a "weight loss program" and did it on my own I will be denied. Am I reading too much into this?? :help:

fluffy, i'm so sorry to hear that. i'm very hesitant to tell people of my surgery also... i dont want to get all excited then get denied. i HATE thinking that way.. but ya kinda have to prepare yourself. i've always been that way though.. never wanted to jinx myself!! hopefully everything will get settled soon.

Endoscopy was a piece of cake... ok, um.. wrong choice of words.. haha.. it was EASY. I was more nervous about my pending surgical pre auth. I stopped by the surgeon's office on my way to the hospital and dropped off more supporting paperwork for them to send off to BC/BS...when I was there I was told the insurance girl was on the phone with BC/BS for my auth. Keep your fingers crossed for the approval!!!

Endoscopy was a piece of cake... ok, um.. wrong choice of words.. haha.. it was EASY. I was more nervous about my pending surgical pre auth. I stopped by the surgeon's office on my way to the hospital and dropped off more supporting paperwork for them to send off to BC/BS...when I was there I was told the insurance girl was on the phone with BC/BS for my auth. Keep your fingers crossed for the approval!!!

Let me know what advise you get... I'm getting married in November .. I'm not going to order my gown until June... but I'm not sure even then if I should order a few sizes smaller. I'd hate to order a gown that has to be altered so much that it no longer looks nice. Any seamstresses out there who can advise us about this?

Lets keep our fingers crossed!! I'm here with both the home phone and cell phone next to me... I'll let you know if I hear anything.