Racshelle
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BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
first see your primary care physician, most all insurance companies require a letter from your PCP to write a letter of medical necessity and medical clearance referring you to a bariatric surgeon. It will be a good idea to write your own and take it to the PCP as most do not know how to write the letter. Search sample letters of medical necessity for bariatric surgery emory healthcare. It should provide you a search result from emory healthcare that offers sample letters of medical necessity that you can tailor to your needs. I did and was approved on my first submission and had my RNY surgery on October 26, 2016. Hope this helps I will be glad to offer you any other information that I can. Also, search on this board BCBS requirements and see what others have said your insurance required for them, there can be some differences based on how your policy is set up versus someone else who has the same insurance. This can also help inform you. Once you see the bariatric surgeon of your choice they will tell you the requirements of your insurance to be approved. Sometime the insurance companies may tell you, sometimes they won't telling you that you must get that information from the bariatric surgeon. -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
first see your primary care physician, most all insurance companies require a letter from your PCP to write a letter of medical necessity and medical clearance referring you to a bariatric surgeon. It will be a good idea to write your own and take it to the PCP as most do not know how to write the letter. Search sample letters of medical necessity for bariatric surgery emory healthcare. It should provide you a search result from emory healthcare that offers sample letters of medical necessity that you can tailor to your needs. I did and was approved on my first submission and had my RNY surgery on October 26, 2016. Hope this helps I will be glad to offer you any other information that I can. -
I have noticed the same, I had a hysterectomy 2 yrs ago. A few weeks after I had intense hot flashed several times a day one after the other. I was put on premarin lowest dose, did not work, dosage increased 0.9 still did not work . Noticed my rather large stomach started getting jiggly, so I stopped. Even on premarin I slept all summer including the winter with a fan blowing on me, did help my husband as he is cold natured. I sweated under my breasts profusely, I could feel the sweat Rolling down. I am 19 dpo, immediately after surgery, I have not had to sleep with the fan on, sure my husband is happy. To be honest before surgery I could take a shower get out and dry myself and a few minutes later I was drenched with sweat. I think I had one few second hotflash, no sweating anymore. Yippee
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Medical Alert Bracelet
Racshelle replied to Redmaxx's topic in POST-Operation Weight Loss Surgery Q&A
As a nurse and RNY I believe it is very necessary due to our altered physiology. There is no way that in an emergency situation EMS or physicians would know initially without a family member's disclosure or an ultrasound, which may not be called for. I ordered a medic alert bracelet from Amazon for $11.99 with free engraving. It will say Gastric bypass: No NSAID'S, No blind NG tubes, No sugar. ICE: two family members phone numbers. We are so delicate now and our lives can be in real danger in an emergency. -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
So great to hear that you are doing well! I was definitely praying for you to have a smooth recovery. Im still waiting to find out my surgery date. I should know one day this week. Are you having any issues getting enough liquids? Sent from my SM-G900T using the BariatricPal App Thank you for your prayers they were and still are needed. I will be glad when you have your surgery date soon. No issues with liquids just really do not want to sip, sip, sip or eat really. I average 4 - 6 cups of Fluid per day and that is only because I make myself drink, I don't feel thirsty, nor hungry. the 1/2 cup of Water to 1/2 of apple juice or allowed fruit juice is sad, especially when the juice is already unsweetened.... I am doing well with the wait of 30 minutes after meals to drink though. -
Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
Congrats!!! I am so glad to hear that! That is happening quick! I don't get mine until November 18th! Good luck! Let me know how it goes! Sent from my iPhone using the BariatricPal App -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
Congratulations, glad to hear from you again, glad you are approved. I think the approval was last Friday. I called today and was told that I was approved. So glad. I have surgery on Wednesday I am doing GB because I have GERD, HBP, sleep Apnea, and borderline glucose levels, GB cures most people of all these problems. 60% for vanity, 40% about getting rid of all the co-morbidities I have. Do you have your surgery date yet?No date yet. My surgeon is on vacation until next Monday so I will have a date by next Friday. Honestly I would do GB if I had any comobididies but the sleeve will have to do. Please let me know how you are after surgery when you are feeling up to it! Sent from my SM-G900T using the BariatricPal App I will keep you posted. I had RNY surgery on October 26th I have not been in any pain at all. The only problems I had was feeling nauseated/queasy really more like motion sickness. I spent two days at the hospital feeling this way. Once I got home Friday October 28th, I was able to go to solve my nausea/sick queasy/motion sickness feeling, I am a nurse. I was able to get some real rest as well. I am very grateful for the opportunity to have the surgery paid for at 100% by my insurance company. I no longer have high blood pressure, GERD is dramatically improved no reflux, still a little coughing now and then, no sneezing as I was several times a day almost every day, due to hiatal hernia correction I no longer choke when drinking. Sleep apnea, no longer tired throughout the day when I have decided it is time to get out of bed. Due to sickness and lack of sleep being awakened every two hours to walk even while telling the nurses I was sick, I have spent most of my time resting this week and trying to eat and stay hydrated. I plan next week as I am stabilizing now to begin my exercise to get my weight loss going quicker. Still a little tired, a little woosy when walking and a little spacey sometimes when talkiing but no pain at all and not taking any medicine as of today and still doing good. I do understand why after surgery it takes a little more time to come back and post experiences. My post-op is November 8th, hope I can show some numerical weight loss, thank goodness I voted early. oh, I never took one drop of pain medicine and did not have my prescription for oxycodone filled. I had a great surgeon and I have a high tolerance for necessary pain. -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
November 2, 2016 Congratulations, glad to hear from you again, glad you are approved. I think the approval was last Friday. I called today and was told that I was approved. So glad. I have surgery on Wednesday I am doing GB because I have GERD, HBP, sleep Apnea, and borderline glucose levels, GB cures most people of all these problems. 60% for vanity, 40% about getting rid of all the co-morbidities I have. Do you have your surgery date yet?No date yet. My surgeon is on vacation until next Monday so I will have a date by next Friday. Honestly I would do GB if I had any comobididies but the sleeve will have to do. Please let me know how you are after surgery when you are feeling up to it! Sent from my SM-G900T using the BariatricPal AppI will keep you posted. I had RNY surgery on October 26th I have not been in any pain at all. The only problems I had was feeling nauseated/queasy really more like motion sickness. I spent two days at the hospital feeling this way. Once I got home Friday October 28th, I was able to go to solve my nausea/sick queasy/motion sickness feeling, I am a nurse. I was able to get some real rest as well. I am very grateful for the opportunity to have the surgery paid for at 100% by my insurance company. I no longer have high blood pressure, GERD is dramatically improved no reflux, still a little coughing now and then, no sneezing as I was several times a day almost every day, due to hiatal hernia correction I no longer choke when drinking. Sleep apnea, no longer tired throughout the day when I have decided it is time to get out of bed. Due to sickness and lack of sleep being awakened every two hours to walk even while telling the nurses I was sick, I have spent most of my time resting this week and trying to eat and stay hydrated. I plan next week as I am stabilizing now to begin my exercise to get my weight loss going quicker. Still a little tired, a little woosy when walking and a little spacey sometimes when talkiing but no pain at all and not taking any medicine as of today and still doing good. I do understand why after surgery it takes a little more time to come back and post experiences. My post-op is November 8th, hope I can show some numerical weight loss, thank goodness I voted early. -
Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
Congrats!!! I am so glad to hear that! That is happening quick! I don't get mine until November 18th! Good luck! Let me know how it goes! Sent from my iPhone using the BariatricPal App Thanks, I will keep you updated. Surgery is at 12:30 am. -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
Congratulations, glad to hear from you again, glad you are approved. I think the approval was last Friday. I called today and was told that I was approved. So glad. I have surgery on Wednesday I am doing GB because I have GERD, HBP, sleep Apnea, and borderline glucose levels, GB cures most people of all these problems. 60% for vanity, 40% about getting rid of all the co-morbidities I have. Do you have your surgery date yet?No date yet. My surgeon is on vacation until next Monday so I will have a date by next Friday. Honestly I would do GB if I had any comobididies but the sleeve will have to do. Please let me know how you are after surgery when you are feeling up to it! Sent from my SM-G900T using the BariatricPal App I will keep you posted. -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
Congratulations, glad to hear from you again, glad you are approved. I think the approval was last Friday. I called today and was told that I was approved. So glad. I have surgery on Wednesday I am doing GB because I have GERD, HBP, sleep Apnea, and borderline glucose levels, GB cures most people of all these problems. 60% for vanity, 40% about getting rid of all the co-morbidities I have. Do you have your surgery date yet? -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
I was approved by BCBSIL. Found out today, thank goodness. I completed my pre-op appointment today and am on the schedule for gastric bypass on this Wednesday at 12:30 afternoon. Went out and bought sugar free popsicles, wylers sugar free singles, Apple juice, white grape juice, sugar free Jello and chicken broth. Tomorrow is the clear liquid diet, so I will have those items and I have to do a bowel prep. Not looking forward to the bowel prep...... Glad things are moving on. Appointment with Dr. Macik on October 4th, submission to insurance 10/10/16, BCBSIL/Teamcare approval 10/24/16, surgery 10/26/16. I thank God for his blessings. -
Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
Wanted to let you know that I was approved by BCBSIL. Found out today, thank goodness. I completed my pre-op appointment today and am on the schedule for gastric bypass on this Wednesday at 12:30 afternoon. Went out and bought sugar free popsicles, wylers sugar free singles, Apple juice, white grape juice, sugar free Jello and chicken broth. Tomorrow is the clear liquid diet, so I will have those items and I have to do a bowel prep. Not looking forward to the bowel prep...... Glad things are moving on. Appointment with Dr. Macik, Northside Bariatric Surgery Center on October 4th, submission to insurance 10/10/16, BCBSIL/Teamcare approval 10/24/16, surgery 10/26/16. I thank God for his blessings. -
I am sorry to hear of the stricture. I am hopeful that the endoscopy to stretch your esophagus will help give you the relief that you need. As soon as you are up to it, please keep me posted on how the endoscopy went and if things are better for you.Thank you. 12:30 today. Hoping this does the trick Sent from my iPhone using the BariatricPal App Just checking on you, how are you feeling do you feel any relief? I hope so. How are you feeling today, did the procedure work? Wanted to let you know that I was approved by BCBSIL. Found out today, thank goodness. I completed my pre-op appointment today and am on the schedule for gastric bypass on this Wednesday at 12:30 afternoon. Went out and bought sugar free popsicles, wylers sugar free singles, Apple juice, white grape juice, chicken broth. Tomorrow is the clear liquid diet, so I will have those items and I have to do a bowel prep. Not looking forward to the bowel prep...... Glad things are moving on. Appointment with Dr. Macik on October 4th, submission to insurance 10/10/16, BCBSIL/Teamcare approval 10/24/16, surgery 10/26/16. I thank God for his blessings.
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I am sorry to hear of the stricture. I am hopeful that the endoscopy to stretch your esophagus will help give you the relief that you need. As soon as you are up to it, please keep me posted on how the endoscopy went and if things are better for you.Thank you. 12:30 today. Hoping this does the trick Sent from my iPhone using the BariatricPal App Just checking on you, how are you feeling do you feel any relief? I hope so.
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I am sorry to hear of the stricture. I am hopeful that the endoscopy to stretch your esophagus will help give you the relief that you need. As soon as you are up to it, please keep me posted on how the endoscopy went and if things are better for you.
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I used bariatricpsychevaluations.com and my surgeon accepted it, it was real but not overbearing. My insurance even paid for it, I only had a copay of $20.00 for the service. They completed my report and sent it to my surgeon within 2 days. I checked here before I used them to see that some others had used them. If you do not have insurance the cost is $150.00. You do part of the evaluation online and then have a psychologist call you for the second half, they ask questions in regards of what you eat, how much do you eat, do you exercise have you ever experienced any trauma. The beginning of the conversation I was asked to recall my weight and the changes in my weight from a child to a young adult to now. The online portion tells them more about behavioral/thought processes. I had an appointment the next day, they have a section where you can put in your insurance to be verified and they have an appointment calendar where you can choose an appointment. I called because the appointment I wanted the next day would not let me choose it, no problem they set the appointment I wanted on their end. I was told around the time to be at home in a quiet comfortable place for the phone interview, I did and I had my psych exam. I had an appointment for October 17th at a local psychologist, I kept the appointment until I knew everything was going to be ok. Everything was ok, and I cancelled it several days before my appointment. Some here have said that their insurance did not pay for the evaluation, some have said that they had an out of pocket that was very expensive. I was willing to pay the entire $150.00 if I had to, but only had to pay $20.00 copay. Before I cancelled my local appointment I received a message that was advising me I would have had to pay $70.00 or more to the local psychologist. I came out on top with bariatricpsychevaluations.com.
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How are you feeling? How was the dreaded two days before surgery and the two days after surgery. I am also curious as to how things are going for you on the diet stage that you are in? The only thing that scares me is being on a total liquid diet after surgery for several weeks. I have so many questions, if you had a job that did not require lifting would you have felt well enough (minus being tired- I always am, I have sleep apnea) to go back to work in 5 days? I had an open hysterectomy on 12/26/14 was well enough to be discharged on 12/28/16, never really felt very much pain, still have plenty of vicodin left from that adventure. I am thinking that with lap surgery I should do much better and be able to go back to work in 5 days that is if BCBSIL will go ahead and approve my surgery by next Tuesday. My surgeon's office put me on the schedule for next Wednesday the 26th just in case I get the approval, if not the surgery date will be canceled. Hoping BCBSIL will come through for me.
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duplicate, forgot to use quote
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My BMI is 40.8, I have four co-morbidities: sleep apnea, HTN, borderline glucose levels and GERD/reflux. I did six months of a diet plan in advance of my surgical consult just in case it was required and it was documented on my letter of medical necessity. My surgeon is from a blue distinction hospital. I passed my psych exam, did a nutritional consult, a physical, chest x-ray and EKG and provided a lot of documentation to my surgeon's office for them to choose to submit or not. I have BCBS IL through Teamcare too, my file was submitted on 10/10 still waiting for my approval. I am so glad to for your post, it gives me hope with all the documentation (13 pages) my surgeon chose to send that once they assign my file for review that I can be approved quickly without any problems. How long did it take to get your approval? Also how long did it take to approve your in patient stay at the blue distinction hospital you chose? I was advised by teamcare that they would pay 100%, did you have any out of pocket if your surgeon used a assisting surgeon? So glad for your post and knowledge.
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Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
October 17, 2016 My paperwork was submitted last week on the 10th of October. Called BCBSIL today and spoke with a really nice lady who took her time speaking with me, glad for that. She advised that right now my file had not been assigned to a nurse for review, she told me to give it a couple days to call back for an update. Getting close to the 15 day decision period which would be October 28th. -
Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
Thmitchell, mshaw, I really appreciate your support, I am surprised at myself, that I actually feel like I do not want to call anymore. The reason why my calls might not be as welcomed is that my benefits are held by teamcare a UPS insurance, although BCBS Illinois is on my insurance card. Teamcare has BCBS Illinois to do the medical review and a recommendation of their findings for bariatric surgery. Once the medical review and recommendation of findings is complete they send the information back to teamcare who has the final decision. I feel so very out of sorts and am sorry to feel that my medical review and approval is secondary to those who are BCBS subscribers, not through a third party relationship. They would not give me any information about my clearances, I had to get that from my surgeon and they will not tell me the outcome of their review, just that there has been one and that I need to call teamcare to get my answers. It is not an easy or fair position to be in. I called teamcare today to let them know what happened. -
Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
Thmitchell Thanks for your response. My file was submitted on 10/10. I had been calling everyday to see if there is any new progress. Today I spoke with someone who without directly saying so inferred that I should not call everyday. She also said that many requests were submitted lately. I am glad that you received your approval yesterday. Hope I will receive my approval very soon. Racshelle -
Hoping for a quick approval.....
Racshelle replied to ereese310's topic in PRE-Operation Weight Loss Surgery Q&A
Chylyn, Did you receive your fast approval from BCBS Illinois? Thanks, Racshelle -
BCBS requirements
Racshelle replied to mommabear2311's topic in PRE-Operation Weight Loss Surgery Q&A
Thanks. It went well. I will be cleared, the psychologist just wanted me to attend one support group before surgery and to attend support groups after surgery. Racshelle