GoneFishin

Exercise will replace fat with muscle

I went to one of their seminars when they came to Port Angeles. They seemed very professional and knowledgable and I would have had my surgery by them, but they are not a "prefered provider" to my insurance. Insurance would have participated, but not paid as much. If you don't have that problem or are self-pay, I think they would be a good choice. All the office personnel are banded, so they have been where you will be. Good luck.

Like one firefly said to the other.....YOU GLOW, GIRL!

I expect I have less air into my stomach now than when I was breathing (snoring) through my mouth B4 the CPAP. At any rate, I'm sure it's low-cal air. As for my CPAP, I never knew I could sleep so well. It took me about 20 minutes to get used to it. Can't picture sleeping without it now. I even wake up to find my wife in the same bed with me!

horseygirl, are you still happy with Dr. Hunter? My PCP here in Sequim referred me to him. I jumped thru all the hoops, then discovered my employer has WLS excluded from their group plan. Currently appealing thru obesitylaw.com I only need cunsultations with the nutritionist and anasthesiologist before surgery. Anyhow, how is Hunter and staff treating you?...Dan.

Don't beat yourself up. You are a good person and are trying. I don't know if it would work for you, but the VA hospitals in Portland and San Francisco do Lap Band. I have heard good things about Portland. Thanks to both of you for your service to our country.

Below is the link to BCBSIL medical policy for bariatric surgery. It should open by clicking on it, If not, copy and paste it into your web browser address bar. I gives you all the requirements and details...Dan. BCBSIL/Provider

BCBSIL will be looking for a history of morbid obesity coupled with prior attempts at successful weight loss. Your record of weighs during your normal visits will hopefully verify your overweight condition during this period. If your physician has recommended or prescribed and weight loss treatment for you during that period, ask him/her to find those records for you. Also, document anything you have done on your own ie: any formal weight loss program, exercise regimend, weight loss medications etc. You need to show that you have tried unsuccessfully to permanently loose weight. If you have not been seeing your current PCP for five years, they should have your medical records from your former doctor. If not, have him/her request them. Plan on BCBSIL jacking you around, it's just what they do. The more documentation you give them initially, the better. Best of luck.

Cigna is not my insurer and I am not familiar with their requirements but, having dealt with BCBS, I suggest that you INSIST that your surgeon comply with all Cigna's requirements and submit all the information initially. My experience is that your insurer will not approve your surgery without it. Delay will only cost you precious time down the road.

ashleyb Thank you and your husband for your service to our country.

Years ago, I had my gall bladder removed. It was an "open" surgery, as the Dr. said it was the "gall bladder from hell'. Over time, my navel became an "outie" because of the gall bladder and other prior abdominal surgeries. My LB surgeon said he can fix the outie at the same time he bands me. Between that and losing 120 lbs, I could look a lot better in my speedos a year from now (lol). Just curious if anyone has had that procedure? Did it work okay? Thanks.

I was able to secure their services yesterday. I am greatly releived to have them accept my case. Walter called and we became friends almost instantly. Having dealt with laywers in the past, I don't see how they can do it for the price they charge. So how areyou feeling?....Dan.

lipstix64 I am not yet banded and I appreciate your explanation.

Yes, I have heard good things about him also. So, you're about a month out. How's it going?

I am so HAPPY! for you. Did you appeal on you own, or use an advocate/attorney? I just completed a year of insurance co. hoops and appeals, and only then told that my employer's plan excludes Lap Band. At this point, I think I will ask Lindstron at obesitylaw.com to appeal the exclusion, if he will accept the case. I think he has as good a record as anyone and seems very sincere. Again, congrats! Dan.

Maggie, Who is your insurer and is the policy through your work?

Just curious if anyone has been recently approved by BCBS of IL as a member of the United Airlines group? I have been jumping through the BCBSIL hoops for close to a year. First denied for lack of documentation of the 6 mo. diet. Got that straightened out, now denied because they say UAL has a Lap Band exclusion. No explanation why they didn't tell me this before now, but if it's true, it must be very recent. In that case, I will petition to be "grandfathered" as I started before the exclusion. Any input you can provide would be very helpful and much appreciated. Thanks ....Dan.

Kimberly, I know and have faith in the power of prayer. Thank you for invoking it upon me. It will all work out according to HIS plan. Dan.

I discovered the same thing just today after a year of preparation and jumping through the insuance co. (BCBSIL) hoops, being initially denied because of Weight Watchers documentation, and appealing. I call every day to check the status of my appeal, send in the "additional information" they request and play all their games. Just today they said that I am denied because my employer, United Airlines, has exempted WLS from their policy. This was NEVER mentioned by either BCBSIL or UAL in all my conversations with them, but they say it's in the full text benefits summary, which nobody ever gets a copy of. The exclusion is not refered to anywhere online with either UAL or BCBSIL. There was another UAL/BCBSIL person on this site approved in 12/08 so this change can't be very old. Time for outside help, I think.

jhunter321, I HAVE to talk to you. I am retired from United Airlines and was just denied by BCBSIL, they said that WLS is an exclusion on UAL's policy! PLEASE tell me anything you might know. Thanks. dan.ramberg@gmail.com

I received the letter of rejection today citing the 6 mo. non-surgical weight loss program as the reason. I did WeightWatchers and lost 17 lbs. My surgeon has all the documentation, so I will check it out further tomorrow. Maybe it just didn't get sent in. Hope it can be salvaged by my 3/03/09 surgery date. If I lose that, it's about a 6 mo. wait for a new date. Can't say I didn't expect this, given what I have read and heard about BCBS IL. I am committed to this surgery and will not relent. Whatever I must do, I will. I'll keep you posted...Dan

Thanks for the reminder. I need to call them today to make sure they received my appeal, which I mailed certified with a return signature of verification. Might wait to see if that comes back in todays mail. Dan.

Did any of you have to jump through BCBS hoops?