wannabslim

Has anyone been 'banded' under CareFirst BCBS PPO (Owings Mills, MD)? According to CareFirst, my plan provides benefits for lapband surgery. However, they consider the procedure an outpatient surgery, and state that they do not pre-approve outpatient procedures. After the procedure has been performed, as claims are received, they are reviewed for payment. I am aware of the requirements before proceeding with the surgery, and have satisfied each (except psychological exam): morbidly obese, psychological exam, structured diet program, weight requirement, etc. The surgeon I plan to use if out-of-network, but the hospital is in the network. Has anyone been approved by CareFirst BCBS PPO for the surgery? If so, was it approved following the procedure? Any information that you can provide would be most appreciated. I don’t want to have the surgery and end up being responsible for the cost of the entire surgery.

Is there a tutorial somewhere, that tells you how to use this system? I'm having a hard time, and I am in the IT field.