PlBren

Interesting. I too have arthritis - two knee replacements. And was told that is nothing the insurance would consider. I don't understand how one insurance co can appear to be so different based on the Surgeon you chose. Frustrating!

Here is my update. Person in Dr office tells me she submitted everything electronically on Monday Aug 8th. I asked if I should call BCBS myself to check. She tells me I would only get customer service and they don't know anything. I wait one week - call her and leave a message. She returns call and leaves me a message saying the insurance company says my case is still pending. Not knowing what that means exactly and knowing how hard it is to get her on the phone, I call customer service for BCBS FEP today. They tell me they have nothing on record and no indication of any open case - which there should be since it has been 8 days. He suggested I have them double check. So back on the phone to my doctors office. Explain my concern in a message. She calls back - repeats the pending comment and tells me how often she hears patients who have told her the same thing (that the insurance company says they have no paperwork). She tells me she has confirmation that they do have it: 1) a faxed confirmation that they got everything and 2) that she talked to the right people there (not customer service reps) who told her it was pending. She repeats that customer service doesn't know squat. She then told me I would be the first person she calls when she hears something (which was a polite way of saying - stop bugging me). Any of you other FEP folks - did you actually get any useful info in the first week to 10 days from customer service?

Can you share with me what Number to call? The insurance person at my doctors office said it wouldn't do any good for me to call that I'd just get a customer service rep who won't know anything until after the doctor is told.

Complications on your sleeve? Anything we future sleevers should be concerned about - or ask our surgeons about? Where in VA are you? My whole family lives in VA - Herndon, Manassas and Charlottesville.

I am....SleevenChica - Your profile says CO (I assumed Colorado). I am having the procedure done in Rockville. How about you? No, I am in VA. I lived in Colombia when I had my sleeve. It's really CB. I just don't think back then CB was an option I'm confused. What does CB mean? Where was your surgery?

So jealous!! I will be 3 days tomorrow and doubt I will hear anything. Even my doctor told me to not bug them until after a week. What was your BMI pre-surgery? Did you have any co-morbidities?

I am.... SleevenChica - Your profile says CO (I assumed Colorado). I am having the procedure done in Rockville. How about you?

Are any of you BC/BS Federal employee folks in the DC area like me?

I also have basic. Here are my charges to date - Four visits to the surgeon (my "weight loss consultations for 3 months) - $35 copay each so $140 total Nutritionist visits (2) and Exercise Consults (2) - $300 Psychologist evaluation - $25 copay (but I am choosing to go to her for consults through the surgery so I'm paying an extra $200 not required. EDG copay $100 Abdominal sonogram and chest Xray (done on the same visit) $35 copay So - total to date - without any approval as of yet - $700. But, I had my sleep study and blood work already done previously. Expected additional cost - EKG - $25 copay More blood work - $25 copay Hospital/Surgical copay - $350 So $400 more....Assuming I get approved! Patty - 2 days post insurance submittal...waiting for approval or denial...

I have BCBS federal with a BMI of 38 and moderate sleep apnea but no other comorbidities. My paperwork was just filed on Monday - Aug 3rd so as of now, I don't know if I will be approved or not. I also have a hiatal hernia that will be repaired at the same time so I hope they take that into consideration.

I had my sleep study done 2.5 years ago and was diagnosed with moderate sleep apnea. I didn't have to redo that test. I too hated it!

Did they submit? Yes - I called back today and was told the paperwork was submitted. Now they waiting game begins. I was told give it a full week before I start bugging them.

Lisa - How long did your approval take? What is your BMI and do you have any co-morbidities?

I just found out that my doctors office still hasn't submitted my paperwork to BC/BS Fed yet - and it has been 11 days since my last visit and everything was ready to go then! Ugh. If the insurance company doesn't get back to me in a week or less, I'm going to have to change my whole schedule around because I was counting on a Aug 27th surgery date.

Like many of the folks on this forum, I am dreading my pre-op diet and wondering how to get through two weeks of liquids only. I've read countless accounts of people who have done it and most say that the first 1, 2 or 3 days is the worst, then your body sort of adjusted. I had no idea what that really felt like and so I found it of little comfort. I am a month away from surgery (hopefully - waiting for approval) and so I am not yet on the pre-diet but I wanted to give it a try anyway, just to see what it was going to be like. And so I did a 48 hour liquid only diet last week. And it has helped me feel as if I can do the full two weeks. This is what I did - it was a 48 hours, but over 3 day, trial. I started one evening - dinner time (after having a normal Breakfast and lunch that day). I had a shake and a sugar free popsicle for dinner. And the next day - it was all liquid. And then the next day - I did liquids for breakfast and lunch and then had a normal dinner. I will say that the 2nd day was hard. But I made it a challenge - told myself I could do it and then I just dealt with the hunger. I had a lot that day - anything to help with the hunger - three Protein shakes, two servings of chicken broth Soup, lots and lots of Water, 3 popsicles and 1 serving of Jello. But I did it. And when I woke up on the 3rd day, I wasn't hungry until 9:00am. And that day, I didn't struggle at all. Sure, I was still hungry, but not the deep, I can't think of anything but food hunger that I had felt the day before. It was more like - oh yeah, maybe I should eat something hunger. And before I knew it, it was dinner time and my trial was over. And I didn't even pig out that night for dinner. I didn't need to - I was satisfied with a small meal. I know everyone is different and thus it might take longer to get over that initial feeling of "starving", but now I know not to look at this as a two week diet, but instead - taking it day by day, challenging myself to do it and now I know it will get easier to deal with the hunger.

I have a friend who had the surgery 8 months ago. She had two glasses of wine with her normal dinner (of which she took home 1/2 of it). She says 2 drinks is now her max.

I also had concerns about my weight and me not getting approved if I dropped a lot. I have a 3 month period for weight management. I lost about a pound every month so my BMI didn't go down hardly at all. I am waiting to hear from the insurance co.

That is great you were approved, but horrible of the doctor to not tell you themselves! Can I ask if you have any co-morbidities? I only have the sleep apnea, and history of being overweight, but my BMI is only 38.

SleevenChicka - You wrote: This is from the brochure: Benefits for the surgical treatment of morbid obesity, performed on an inpatient or outpatient basis, are subject to the pre-surgical requirements listed below. The member must meet all requirements. − Diagnosis of morbid obesity (as defined on page 62) 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 40 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 clearance of the member’s ability to understand and adhere to the pre- and post-operative program, based on a psychological assessment performed by a licensed professional mental health practitioner (see page 97 for our payment levels for mental health services) − Member has not smoked in the 6 months prior to surgery − Member has not been treated for substance abuse for 1 year prior to surgery and there is no evidence of substance abuse during the 1-year period prior to surgery Where did you read this? I am on the fepblue.org website now and see absolutely no information at all about bariatric weight loss surgery. My info is getting submitted this week - now I am getting worried. Also - for those of you who have BC/BS Federal, do you have basic or standard option?

I found out yesterday that I also have a hernia. My doctor told me that she plans to correct it during my sleeve surgery. She didn't think it was a big deal and not an issue to do them both at the same time. I specifically asked if it would add to my recovery time and she said no. My surgery is not yet scheduled, waiting for insurance approval - but I should be having it in about 5 weeks if approval goes well.

I find it interesting that the pre-op diet is so different doctor to doctor. Not patient to patient. Which tells me that it isn't a do or die situation. How can they operate on some folks who haven't done an all liquid phase before the surgery if it is that critical? My doc says 2 weeks. And one week before that - she says two Protein shake meals and one regular meal a day - so I have a 3 week pre-op diet. Like what Muzical1 did - I can't imagine it is much of an issue if you eat solids at the start of the pre-op diet. I also think that last week is when you want to be very strict about everything.

I also have BC/BS and a BMI of 38. My Dr. is submitting my paperwork sometime next week. I've had a history of having a BMI over 35 for about 6 years now. And I have moderate sleep apnea. I can't imagine that you will not be approved. I think I am much more borderline than you. Wishing you good thoughts and hope we both get approved!

i will be starting my pre-op two week diet in about a Month - the day I return from vacation. I know I am going to feel awful. I can't imagine going that long without solid food. And when I am hungry - I can't concentrate or sleep. How did you get thru it? Advice needed!

I too am worried about the pre-diet. Like you - my social life is meeting friends for dinner or happy hour and going to hear live music with a picnic dinner. With the pre-diet - I am fearful of cheating. Because I know I will be hungry. But, I am limiting my social life during that time period. But I still worry - if I am home alone, I'll be hungry and still want to eat. Once I have the surgery, I am not as worried. I know that I won't be hungry. Thus, I won't feel the need to limit my social life. I probably will the first two weeks after surgery, just because I'll be recovering and still on a liquid diet, but after that - I look forward to going out to eat - and ordering something like an appetizer and Water and not being able to finish it. Think of the money you'll save!

As far as I know - as the patient - you have a right to read any report they write. So Lisa - you should ask your surgeon for a copy. Same thing scarlep - when your psychologist writes it - ask for a copy. I did, and I got one directly from my psychologist.