KayKay

I was banded on Wednesday (4/28/09):wink: A DREAM THAT HAS CAME TRUE:thumbup: but I have a question for you that have experience with the lap band. Why am I not feeling full? I am eating like I am suppose to but am still hungry. Now I will say I feel fuller a whole lot sooner, but shouldn't I feel full really fast? I think I am to go in to the doctors office in about two weeks for a fill, does the fill make a difference when filling fuller sooner? I mean I thought with just the surgery I would see a hugh difference. Any advice is greatly appreciated! Thank you so much!!!!!!!!!!!!!!!!!!

Keep Fighting And Don"t Give Up!! I Am In A Battle With My Insurance As Well! I Hope You Get Good News!!!!!

:confused2: I was denied Lap Band surgery and have filed a grievance letter, They wrote back and stated that they had received the grievance letter and would be turned over for review, letter states that case will be reviewed with 30 calender days and with in five working days of review I would revieve a letter upon the determination. BCBS of TN received grievance letter on March 20, 2008, I have called back constantly everyday, today when I called BCBS of TN the lady stated that the Grievance Department had not made a decision. What????????? What should I do? They have already had 30days, and nothing has been decided, when I call the department I just get the answering machine or a lady states she will get the message to the department. I mean this is a life altering decision for me, why should my life be put on hold. I remain very polite to BCBS of TN put my patients are running thin. Any suggestions?

I just found it. It states that Based on the information recieved and the terms of your health benifit plan, we determined that the requested service is not Medically Necessary. However my doctor states that it is necessary for my health.- He stated before and is putting in writing to send to BC of TN. Any suggestions, I am so tired of being over weight!!!!!!!!!!!!!!!!1

I have BC of TN-They stated that evidence did not support and they did not feel like it was medically necessay. However my BMI is 39.6 and I have co mor. problems and have been able to supply medical documentation that I have been obese for the past five years.

I have just been denied lap band surgery for what ever reason.I am so depressed at this point and jsut thinking about giving up. :thumbup: Could someone PLEASE help me with information in regards to an appeal????? Any suggestions?

I am a first grade teacher! I love my job but wish I had more energy while at work. I am waiting to here back from the insurance company (BCBS of TN), before having surgery. Any other teachers here have BCBS of TN? If so how was your experience? By the way I enjoy reading post on this topic!!!

:smile2: According to medical records five years ago my BMI was at 34.4 as of today it is 40, I am awaiting to hear back from insurance to see if I will be approved. Any suggestions or has anyone dealt with BCBS of TN in reference to getting covered for LapBand Surgery?

Ok here goes. I have BCBS of Tennessee, I know that insurances and policies are different, I meet all the requirments for the Lap Band Surgery with the exception of losing 10% of body weight (if I could lose the 10% of body weight what's the point of having the surgery) anyways, the following is in the insurance in order for them to pay: ****************************************************** <LI class=kadov-P>The attending physician must submit evidence that the attempt at conservative management was within two (2) years prior to the planned surgery; and <LI class=kadov-P>The attending physician must submit records that the individual has successfully lost 10% of initial body weight prior to the date that the authorization is requested; ******************************************************* Can someone help me make heads or tails of this? Maybe I am just worried since I am scheduled to have lap band suregery in two weeks, Like the rest of you, if I could lose weight then why have the surgery. Any advise is greatly apperciated!! Best regards, KayKay :help:

I am in the same boat with you. I am a mother to a three year old and made the decision to have the LB done, I have meet all the criteria and just awaiting the approval from the insurance company.. Good luck, I'm glad to know that I am not the only newbie here. So when is your surgery scheduled?

I know that insurance companies are different as day and night. If you don't mind me asking, was you suppose to me monitored for at least a two year period (noting that you were being treated for Obesity and unable to maintain weight loss)

Oh my, 6mths? I have BCBS.

:)Can some one give some idea as to how long it took for their insurance to approve the Lap Band Surgery? (I meet all the criteria to have the surgery) Thanks