nursenky9

Hi Shelly, I have highmark bcbs ppo. The ins. co received my paperwork on 7/7/08. My initial 6 mo supervised diet was on 6/26/06. The ins requires 6 mo cumulative supervised diet 2 yrs prior to surgery. They will not use the 6/26 of course b/c it is over 2 yrs. Just found this out today. Getting very disappointed. I have to come up with another month. Good luck to you!! I am in Lex, KY

I have sent my paperwork in for the lapband. Ins received it 7/7 it is highmark BCBS they called wanting to know the name of doc for one of the wt loss centers I used. I had LA wt loss, curves, Total Med Supervised wt loss center, ageless wt loss center-doc supervised, and wt watchers. They require 6 mo supervised wt loss over a 2yr period. I had 10mo. Done the nutritist and psych evals and the seminar. I have read alot on the lapband and the RNY. Seminar included the gastric sleeve. The more I read I am drawn to the gastric sleeve the wt loss is fast however you do not have the malabsorption as ith the RNY. Problem though is the gastric sleeve is still seen as experimental and ins will not pay for it. I have been a nurse for a long time and out of the WLS I think the sleeve would provide the best results with the least amt of complications. No slippage, flipping, erosion, or malabsorption.

No, I do not live in PA I work for Select Specialty Hosp. that is based out of Mechanicsburg, PA. This is the ins they carry. I went to their hospital in Hattiesburg for a visit. How have u done with your lapband? I am just so anxious waiting on the approval. Don't want a denial. Good luck and thanks for responding. ET

I have highmark bcbs of PA and they received my paper work on 7/7/07 and today they contacted my surgeon wanting the docs name for the wt loss program I attended. ET

That is so GREAT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Hi Courtney, I have Highmark BCBS they received my info on 7/7. I received a call today saying they could not make the doc on one of my supervised wt loss programs. The BCBS I have requires a 6 mo cumulative within the last 2 yrs. So I am hoping I get approved soon. Good luck to you. ET

I have highmark BCBS the surgeon's office submitted my stuff on July 3, waiting. Good luck

Heather: I have Highmark BCBS. All of my info was faxed on July 3. I have not heard anything. The ins lady at the docs office said they told her it could take from 48hrs up to 6 wks. I read the booklet from BCBS and it said for pre cert they are suppose to give you a response within 15 days of them receiving it. Hopefully we will all be hearing something soon.

Cheryl: My doc is Dr. Oldham with Bluegrass Bariatric they are in Lexington and Georgetown KY

Dr. Oldham with Bluegrass Bariatrics. They also work at Georgetown Hosp.

that is great. I am awaiting ins approval. I have Highmark BCBS Good luck!! and Congrats!!

Hi Owensboro, My name is Elizabeth and I live in Lex ky. I am awaiting ins. approval. Good luck

Hi WS, I live in KY and have Highmark of PA. I work for a hospital chain. My surgeon sent my info to the ins on July 3. The ins. told the surgeon's office it could be as little as 48 h (not that lucky) up to 6wks for pre cert or pre determination. I went on line to their website and downloaded their booklet and it said that for precert they will notify in writing within 15 days of their receiving the info of their decision. I have all the supervised wt loss info exercise log psych eval and nutritional consult. Hopefully we will both hear some positive news soon. Let me know.

What kind of ins. did you have? MY surgeon sent my info in on July 3 have not heard anything. I have Highmark BCBS. Good luck.

Hi LaDonna: My name is Elizabeth, I am in Lexington, KY. My info is going to the ins. co. tomorrow. Good luck on the 8th. ET

Hello!! I weight 229.5 pounds and my BMI is 39.4. I have dyslipidemia, joint problems, back problems, and problems with my knees. I have given my physician all my info. 11mo over the past 24 mo supervised wt loss membership to Curves and YMCA. Recommendation from my PCP, and the Pych and nutritional evals. Also labs. I spoke to my insurance company: highmark bcbs ppo(PA) today and they are saying that for predetermination for lapband it takes 4 to 6 weeks. They told me if it is inpatient it can be authorized over the telephone. My surgeon will not be back until Tues., July 1, 2008 to sign the paper work. This must be done before the office will contact the insurance. Anyone know anything about this ins? or what I should do? Wanting to hurry up and get it over with. Wanting a ring around my belly, Nursenky9

tas: I have highmark bcbs ppo out of PA. I live in KY and work for hospital that is head quartered in PA. BCBS sent me a copy of their policy on wt loss. It reads a cumulative 6mo wt loss on the previous 2 yrs prior to surgery, psych, & nutrition eval. I have all the info. The surgeon is out of town and will be back tues. 7/1/08. Contact your ins. and have them send you the policy on bariatric surgery. I hope it is not a long wait for the surgery.