Northern Mist

Don't trust them!! I too was told, in very general terms, that I "only" needed to be on a 6 month diet - talk to my nurse or doctor each month with weight taken and fulfill the other requirements (5 year history, pysch eval., nutritionist appt. etc..) and I would be all set with getting the surgery approved. WRONG!! I submitted everything, including a 6 month diet w/doctor, all tests required by insurance and surgeon, even a diet/excersize log for 10 months - they denied me saying my doctor wasn't specific enough in her notes about the diet program I was on and they needed more than weight and blood pressure for five years - they needed a doctors notation stating I was obese for five years!?! The weights and rising blood pressure stated at every physical, every year wasn't good enough??? The 10 month supervised diet wasn't explained fully enough??? My doctor was MAD - she called and wrote a letter stating everything again but it didn't matter. I thought I was dotting my I's and crossing my T's. If I can tell you anything at all - Get specifics from the insurance company, show your doctor and have them be very specific and long winded about your diet and excersize plan. No, I will not give up. I've paid my dues with BCBS IL for 14 years and have never used the insurance beyond the basic check-ups, allergy issues and colds. I have apealed and I will win eventually!

Hi All, I'm, of course, fighting it. My doctor thinks it's ridiculous. They sent me a denial letter stating I didn't have a five year history (I do and sent it) They also said I needed a six month diet history (I did and sent it). My doctor talked directly to BC/BS and they told her she needed to document it better than she did. They are willing to take from November 07 to now - Oh gee thanks. There's nothing different about the diet logs and doctor's notes since July 07! I'm sure once I get 2 more months documented they will find something else. I'm very frustrated. I needed to get this done before my jobs got too busy - looks like I will have to go through this with hardly no down time or I'll have to put it off for a slower month. Sorry for the rant.

Hey DreamTheaterFan - My husband loves the band and is a guitar player (at home not in bars) We also love Knoxville - It's one of the friendliest cities we've ever been. Good luck on your journey!

Yes, I'm joining the ranks of people who're frustrated with an ins. company. Bariatric coordinator faxed in paperwork - BCBS said they didn't receive it. Faxed again 1-18 BCBS said oh, we got it but it's not scanned into the system. Called 1-24 BCBS said it's in syst. you should know in 5-10 bus. days. Called on 2-1 BCBS said it just made it to the pre-determination dept. and I should hear something in 7 to 14 business days. Yep, they are giving me the run around. Kinda expected them to since I've heard they can be difficult. Matter of fact, I don't think I've read anything positive about BCBS IL period!

You need to make sure WW is enough - Most insurances require the doctor/his nurse to see you and make notes every month, for 6 months. If your starting bmi qualifies - this is what they will look at even if you lose a little weight. Verify these things with your insurance company to be sure though.

I sure hope my story turns out positive. My pre-op stuff was turned in last week. Been working on it since May '07. Crossing my fingers!

Never heard of it. I have BCBS of IL too. My paperwork is going in tomorrow - crossing my fingers

Thanks susieq. I'm sure once I get approved and a date I'll have lots of new and old questions! Take care of yourself.

Hi susieq125, I should've been done with my 6 month diet in November but when the paperwork came from the Doctor's office they had my blood pressure in July but not my weight.... so I had to start all over with my 6 consecutive months supervised diet. It was frustrating but what do you do? I'm done this month and Angie should get things submitted to BCBS of IL soon and then it's hurry up and wait! I hope there isn't anything else "missing". Hope your doing well! How was your liquid stages and how long?

I can't tell you how many times I've been in the "normal" size section of a store only to have a skinny salesgirl tell me I'm in the wrong area and point to where I should go. Hello...Like we don't shop for other people!!

Small world!!

Silly me - Everyone has pretty much said the same thing. I promise to read back a little farther before I'm moved to put my two cents in

I'm scared to death not to follow my surgeons advice. How would you know if your stomache's OK after cheating at day 4?? or 14??? I thought the initial liquid stage was so that your stomache wouldn't wiggle around trying to process food and possibly tearing stitches or stretching etc..... It's supposed to basically lay as dormant as possible to give your body time to heal. Regardless of what's paid and how, I'm scared I'll do damage no money will fix.

Doremires......The name sounds very familiar - I bet if I seen the face I would!

I have been going to my doctor since May '07 and getting weighed and my blood pressure taken. July's weight was skipped somehow but my blood pressure was recorded - I had to start the 6 month evaluation all over at that point. I might have seen my doctor 2 or 3 times in this time period but it's been primarily done by the nurse. I've recently read this may be a problem.Please let me know if you've been rejected or accepted with these issues?? BC/BS Illinois Thanks! Misty

I'm almost in the same boat. I have high blood pressure (hypertension) and knee joint pain (arthritis) but that's about it. I don't have diabetes but I was gestational diabetic with both children and I didn't get tested for sleep apnea because I don't really snore. My paperwork should be sent in next week and I'm crossing my fingers. How long did it take to get the rejection from the day you/your doctor filed? What was your BMI? Don't give up!! You have the right to appeal.(sp?) Good Luck!

Hi Jody, I'm glad you found this site. It's great. Lots of information from people who are living it everyday. You will get addicted to it for awhile. I've heard the port pain can be there for while for some people and the stitches inside take awhile to heal too. I think if your still in pain you should take it easy and ease into it as you feel better. I'm having my last test on Friday and January is my last month on my 6 month supervised diet. Hope to have all the paperwork into BC/BS IL. by early next week! I'm excited yet apprehensive at the same time. It seems like some people have major problems getting approved and some get approved in 3 days! Take care and congrats!

Thanks for your reply Trixie. BC/BS of Il. representative and the handbook states 6 consecutive months supervised diet by my primary physician. I'm afraid it's too general and they may say it means the physician has to see me every time not the nurse. It seems like I've been doing this forever. I hope the nurse recording the weights and blood pressures will be OK.

I've never heard of a lack of fiber causing cancer....????

I'm not sure where to start. What exactly got me to this point? Pictures/Mirrors. Looking at myself in pictures/mirrors was always a suprise - pretty soon it wasn't such a suprise anymore. Pain and Depression. I don't think I've been depressed as much as I've been lately. I hurt all the time and I'm having issues with my knees. To carry anything heavy up a step is almost impossible - sometimes it's all I can do to get groceries up two little steps from my garage to my house. I don't want my kids to grow up overweight. They have no idea what this feels like -physically and mentally. My husband is very vocally supportive but I'm afraid his actions are going to sabotage me. He is 110% pro-active with anything new but the newness wears off fast. I can't resist bad things if the're in the house. How am I going to resist bad things if there staring at me all the time? I'm not a candy eater but I pick at it at times - what if it becomes something easily accessable and I start to be a candy eater???? Here's the run down of dates/appointments etc.. Talked about WLS with my doctor - May 07 Attended a seminar in T.C. - May 07 Attended support group meeting - June 07 Attended support group meeting - July 07 Attended Surgeon consultation - Sept. 07 Attended Nutritionist consult - Sept. 07 Attended Psych. Evaluation - Sept. 07 Weights and Blood Pressure done in: May, June, July went to Dr. but not recorded, August, Sept., Oct., Nov., December January will be my 6 month straight weight monitoring. It would've been October if the doctor's office would have recorded it in July!! Yes, I was mad but what could I do?? I really like my doctor and nurse - everyone makes mistakes. I hope to get in all the paperwork in the begining of January. I'm very anxious over the BC/BS determination - I can't sleep because of it and I don't even have my paperwork in yet! I'm hoping for my surgery in Feruary or March - this would work out with both my jobs. It gives me enough time to recover. All for now - MA

I'm not sure where to start. What exactly got me to this point? Pictures/Mirrors. Looking at myself in pictures/mirrors was always a suprise - pretty soon it wasn't such a suprise anymore. Pain and Depression. I don't think I've been depressed as much as I've been lately. I hurt all the time and I'm having issues with my knees. To carry anything heavy up a step is almost impossible - sometimes it's all I can do to get groceries up two little steps from my garage to my house. I don't want my kids to grow up overweight. They have no idea what this feels like -physically and mentally. My husband is very vocally supportive but I'm afraid his actions are going to sabotage me. He is 110% pro-active with anything new but the newness wears off fast. I can't resist bad things if the're in the house. How am I going to resist bad things if there staring at me all the time? I'm not a candy eater but I pick at it at times - what if it becomes something easily accessable and I start to be a candy eater???? Here's the run down of dates/appointments etc.. Talked about WLS with my doctor - May 07 Attended a seminar in T.C. - May 07 Attended support group meeting - June 07 Attended support group meeting - July 07 Attended Surgeon consultation - Sept. 07 Attended Nutritionist consult - Sept. 07 Attended Psych. Evaluation - Sept. 07 Weights and Blood Pressure done in: May, June, July went to Dr. but not recorded, August, Sept., Oct., Nov., December January will be my 6 month straight weight monitoring. It would've been October if the doctor's office would have recorded it in July!! Yes, I was mad but what could I do?? I really like my doctor and nurse - everyone makes mistakes. :cursing: I hope to get in all the paperwork in the begining of January. I'm very anxious over the BC/BS determination - I can't sleep because of it and I don't even have my paperwork in yet! I'm hoping for my surgery in Feruary or March - this would work out with both my jobs. It gives me enough time to recover. All for now - MA

Glad to see some activity on the Michigan site. My last weigh in is in January and then Angie @ T.C. Surgery (Dr. Nizzi) will turn in my paperwork to BC/BS of Illinois. Not sure how long the insurance people will take - I hope not long. It seems I've been doing this forever and ever. Not sure of the exact steps after getting the OK from the insurance (I hope an OK) but I'm getting impatient! Late February to mid March would be the best time to get the surgery done. I live in Grayling and manage a 65 room hotel and a Bed and Breakfast on the AuSable River. Losing some weight will help me keep up with my jobs and my family! Take care.

I'm waiting for the insurance company to respond too. Hope it will be soon. I've been going through th various motions since May. Hurry up and wait is right! Surgery will be done in Traverse City, hopefully sometime in February.

From what I've gathered, it varies. I've read some self payers getting it done within a couple weeks to some taking a year or more. I think it's the requirements set up by insurance companies slowing most people down. Some insurance companies want 12 months documentation and some need 6 months. From what I've seen on the posts most surgeons want you to attend the seminars, get pysch evaluations, and visit the nutritionist etc... prior to surgery. Once you talk to your doctor/surgeon and attend a seminar and contact your insurance company, you'll have a better ideal. (Your health will also play a big role) Good luck and keep researching!

Hi All, They called and scheduled my consultation on the 13th of September - a little further out than I anticipated. I was hoping for August sometime. Now I'm worried they are going to do the tests etc.. required and it's going to put me to close to the new year - I might as well wait so that all my insurance deductibles are met in 2008. I'm so bummed. How long did it take you from consultation to the tests to the actual surgery???? I know this varies - I'm just curious.