Sistabigbones

Hi!!! I am with Peacthree Bariatrics..Got my approval from insurance about 2 weeks ago. Got scheduled thru Lolita at his office for my initial consult with Dr Duncan,EGD,pre Op and surgery. I saw Dr DUncan for my initial appt today!! He is sooooooooo sweet and so full of knowledge...Eased my mind and my husband's (and he is a VERY hard sell)..My pre op appt is 7 27 09 and my egd is 7 29 09...My surgery is scheduled for August 5th...It will come for you but word to the wise....CALL THEM OFTEN!! GOOD LUCK and keep me posted!!!

Sorry that u ladies did not see my post for what it really was. But again, when u are so "ready to attack" u often over look things. I don't have anything negative to say back to anyone. Just really wanted to say that i too was just trying to state my opinion. I wish you all well in your weight loss efforts and think from now on, i will stick to that section of the forum!

Hi ladies!! I too am being banded by Dr Duncan. Just got my surgery date on friday. Will be banded on 8 5 09. My first appt with Dr Duncan is 7 20 09. I was very frustrated at first that I didn't get to meet him before the paperwork was submitted but luckily, even if for some god awful reason, i am not to happy with him when i meet him, changing drs is not that big of a deal..ur approval apporved the surgery and as long as u are using a participating provider, everything else is COOL!!! wishing u ladies the best!!!! keep me posted!

I have taken the time to read each of these posts. I am so sorry that so many of you have had such a hard life/childhood. But sometimes that makes us "jaded". Everything in life is not black or white. Do I know if he abused the people he was accused of abusing? no...What I do know is that someone's father,brother,son is dead and will be missed if only by them. I feel very sorry for the people here that have such "strong" opinions about this when they have undoubtly not been provided all of the facts becasue no one was provided all of the facts. Michael Jackson was a musical genius and will be missed if only for that reason. What I pray is for the healing of some of the people on this site. I pray that you are able to get strength from whatever has happened to you. As far as Michael Jackson is concerned, May he rest in peace becasue even HE deserves that. Be blessed and remember "let he without sin cast the first stone".

Was submitted to insurance on thursday June 25 and i was called today by the blue cross csae manager and informed of my approval!! I am so excited!! Maybe I can get a surgery date in the next few weeks!!!!????? Wish me luck!:blushing::crying:

Was submitted to insurance on thursday June 25 and i was called today by the blue cross csae manager and informed of my approval!! I am so excited!! Maybe I can get a surgery date in the next few weeks!!!!????? Wish me luck!:smile2::thumbup:

Hi! I know things can be frustrating just getting started. I am not sure about the "program fee". I do also have blue cross but mine is blue cross blue shield of ga for whom i work for. Each employer group determines the benefits that they will offer for their employee.. To say that, i mean, u may have blue cross blue shield of ga too but work for let's say the bank. You may not have ANY coverage for WLS because your employer decided not to cover it. But with that being said, blue cross blue shield of ga does not require a 3 month diet. BMI <40 needs comorbid conditions bmi >40 needs no comorbids..will have to do a psych eval, nutritionists appt,medical clearance and some drs want pulmonary and cardiac clearance. Call your customer service number on the back of your card, they can tell you exactly what you need and in most cases, will even mail an intro packet to you related to your weigt loss surgery ie: deductibles,copays,etc.. Hope that helps....

ok.here we go. I had my psych eval on April 23..called the drs office every few days after that trying to see if they had my letter of med necessity ready. was told daily by the secretary in the psych office that they were waiting on my stuff to come back from the transcriptionist.WTF?? So finally, monday MAY 11, i called again at which time i was told the same thing.I told the secretary that it had been 3 weeks and there was no way it was taking that long.so she went to speak with the dr about it. came back on the phone and proceeded to tell me that blue cross had denied their claim because precert was not obtained so they are not releasing my records until blue cross pays them. Now i work for the insurance company so when i made the appt, i walked her step by step on how and where to send her claim and about the need for precert.what more does she expect from me. I can't file the claim for her!! So I called the dept at bluecross that handles the claims and was told that it was denied because she did not get precert AND she submitted the claim to the wrong place(submitted it to psych instead of medical) but recall, i had already told her where to submit and everything.. So i told the lady in claims at BC all of this and she asked me if the psych eval was for clearance. i told her that it was for clearance for my WLS. She told me that she would follow up with the correct area and try to get them to overturn the denial. I have spoken with insurance everyday since then and still no decision yet. It's against the law for the dr to keep my medical record from me but the fact that she is even trying to makes me afraid of what she may write if i cause too big of a stink about the fact that it is against the law. So needless to say, i have a call in to another psych dr and hopefully i can get an appt soon so I can get this show on the road!! I work for the insurance company and am frustrated..imagine the frustration of the people that don't work day to day with this type of mess!! well, wish me luck!! As the Joss Stone song says, "i'm bruised but not broken"!!:smile2::w00t:

ok.here we go. I had my psych eval on April 23..called the drs office every few days after that trying to see if they had my letter of med necessity ready. was told daily by the secretary in the psych office that they were waiting on my stuff to come back from the transcriptionist.WTF?? So finally, monday MAY 11, i called again at which time i was told the same thing.I told the secretary that it had been 3 weeks and there was no way it was taking that long.so she went to speak with the dr about it. came back on the phone and proceeded to tell me that blue cross had denied their claim because precert was not obtained so they are not releasing my records until blue cross pays them. Now i work for the insurance company so when i made the appt, i walked her step by step on how and where to send her claim and about the need for precert.what more does she expect from me. I can't file the claim for her!! So I called the dept at bluecross that handles the claims and was told that it was denied because she did not get precert AND she submitted the claim to the wrong place(submitted it to psych instead of medical) but recall, i had already told her where to submit and everything.. So i told the lady in claims at BC all of this and she asked me if the psych eval was for clearance. i told her that it was for clearance for my WLS. She told me that she would follow up with the correct area and try to get them to overturn the denial. I have spoken with insurance everyday since then and still no decision yet. It's against the law for the dr to keep my medical record from me but the fact that she is even trying to makes me afraid of what she may write if i cause too big of a stink about the fact that it is against the law. So needless to say, i have a call in to another psych dr and hopefully i can get an appt soon so I can get this show on the road!! I work for the insurance company and am frustrated..imagine the frustration of the people that don't work day to day with this type of mess!! well, wish me luck!! As the Joss Stone song says, "i'm bruised but not broken"!!:cursing::w00t:

oh my!!! I had my stress test on yesterday. Picture this, 254 pound woman RUNNING at 5mph on a treadmill with an incline of 4!!! I was about to fall out!!! I had to ask the dr if he thought that was humane. :w00t: I am 254 pounds and there is no way in the world all of my meat should move at one time that fast on that incline and in that heat(the room was about the size of an oversized closet and had no air) The dr thought I was sooo funny!! but needless to say, I survived!! The last thing that i need to do is do my nutrition eval on May 11th and then I will be ready to submit to insurance! I am soooooooooooo excited!!! One step closer!!!

oh my!!! I had my stress test on yesterday. Picture this, 254 pound woman RUNNING at 5mph on a treadmill with an incline of 4!!! I was about to fall out!!! I had to ask the dr if he thought that was humane. I am 254 pounds and there is no way in the world all of my meat should move at one time that fast on that incline and in that heat(the room was about the size of an oversized closet and had no air):wub: The dr thought I was sooo funny!! but needless to say, I survived!! The last thing that i need to do is do my nutrition eval on May 11th and then I will be ready to submit to insurance! I am soooooooooooo excited!!! One step closer!!!:wink:

OK..so I am a healthy person other than being obese(is that possible??):thumbup: But anyway, I have my medical clearance and this morning, I went in for my psych eval. 500+ questions and it took me about 1.5 hours to do it. I will have to wait about 2 weeks to get those results back. I have an echo and stress testing on Monday. My last clearance will be my 3 hour nutrition class on May 11. I will have completed all of my clearances and can submit to insurance at the end of May.:thumbup: Hopefully, I can get a surgery date for sometime in July. I am excited and soooooooo looking forward to this. I know it won't be easy but neither is carrying around 256 pounds on a 5 ft 3 frame!!!:thumbdown: