Cloteal

Yes, I will keep you in my prayers.

I have been thinking about the lapband for quite sometime now. I went to an orientation last week and I am very interested in the lapband. I have only one concern, I have BCBS of North Carolina and I'm not sure if I'll get approved as my BMI is only 39. I'm 5' 1/2", 204 lbs with no health problems. I have tried every diet there is and yet like others have not been successful. I'm ready to change my life, just because I don't have any health problems now don't mean I'm free from them. I'm 41 years old and my mom is morbidly obese and has several health problems. I'm afraid I won't be here to see my grandchildren 1 day. I just don't know what to do, this is driving me crazy.

For those that care and those that don't, I can finally can leave you alone, I know I probably was worsen, but I'M APPROVED!!!!!!!!!!!!!! Thank all that prayed and was concerned. My surgery date is still scheduled for tomorrow. I will keep you posted.

Thank you for your prayers. I will be praying for you to.

Thank all of you that prayed for me and who were just as anxious as I was, but no, I was DENIED! The reasons they gave was a bunch of mess. My BMI was a 40.6, for the past 4 out of 5 years it was a 40, besides now I have high blood pressure which I am now taking meds for, along with acid reflux. Don't know what happened. I called the insurance co to see why they denied my approval they said, because my BMI was below 40 with no comorbidities. Come on the paperwork is right in front of you, I had 2 doctor letters of recommendations stating all these facts, the letter from the surgeon stating that my bmi at that time was a 40.6 and that my blood pressure was high then too. The insurance co also stated that no psych eval was done, no nutrionist eval was completed, which is all false. I was in the surgeons office on yesterday for my group eval, when I was given this news. The clerk there showed me my packet everything that was sent to the insurance co. Nothing in that packet showed my bmi below a 40, the letters from my PCP was there, the psych eval was there, the nutritionist eval was there, WHAT WAS THE INSURANCE CO LOOKING AT? Well, they told me that they were going to do a (PCR) patient courtesy review. I should hear something Monday. I told the insurance co, someone is either falsifying info on my paper or someone is not doing the review. Based on the BCBS policy I meet all requirements. I don't know what else to do. Guess I will be appealling.

Congrats to you!!!!!! Sorry you had to war with BCBS, but you got through it. I'm probably where you were months ago, I'm having the time of my life with BCBS. How did you ever do it?

Congrats to you!!!!!! I'm sorry you had to go to war just to get this done. I'm where you probably were, I am have the time of my life with BCBS.

Ok you guys here is another update, I went to my PCP today to get the additional info that they (the insurance co) requested. My blood pressure was up, they had to put me on BP meds (a plus for me). Now don't get me wrong, I don't won't high blood pressure, but if this is what's going to help me get approved. The acid refux yall is a very terrible feeling, they put me on meds for that as well. My PCP said she will write a letter regarding these issues, and will put on there that this is do to weight gain. Yall pray for me that this will help me get approved. I'll keep you all updated. So far as I know my dates have not changed for surgery, which is 08/13.

No, they didn't give me any suggestions just to revisit with my PCP. I will call Monday to get an appt with my PCP and hopefully she will put me on BP meds. I had my BP checked today at the Drug store and yes, it is still high. I know they say the normal reading for High Hypertension is 140/90. My BP read today 147/95, this is low compared to what is't been. It usually run around 165/106, somewhere around that. Hopefully this will work, just pray for me. How are you doing?

Update. Received another call this evening from my surgeons office, yes BCBS requires additional info on my blood pressure and acid reflux. My primary care provide don't have anything else, I wasn't on any meds as we figured if I get this surgery then my blood pressure would go down. Besides I was only borderline hypertension that could be controlled with eating right and losing weight. Just the past month or so it got really out of control, I didn't go to my Doctor as I didn't want to go on meds (dumb me), but I felt I had a good chance of getting approved. I don't know now what to do. Can anyone help.

Ok you guys, I received a call today from my surgeons office stating that the insurance company need more info before they can approve my surgery. My surgery date was set for 08/13, now that'll probably change. The insurance co is requesting more info from my primary physician, well that info is a 5 year weight history, and a referral letter, I provided all that info to my surgeon, why is my insurance co still requesting that info. I'm wondering if the surgeons office didn't send all my paperwork in. I'm very frustrated and now concerned that I may not get approved. I met the qualifications, I thought, my surgeon said it shouldn't be a problem getting an approval. Then what is the problem! Thanks for listening, just needed to vent.

YES!!!!!!!!!!!!! Congrats to you. I am so excited for you, hopefully we can celebrate together. Pray that mine get approved to.

I'm being banded at Duke, and yes we should call each other afterwards and maybe the night before to see how calm we are (smile). Seems like things are picking up for us.

Update! I finally got a call on yesterday, my surgery date has been scheduled for 08/13 (YEA!!!!) Don't know how to post a smiley face. They said that the only way my date will change if my insurance doesn't come back approved in time, but they don't see why it wouldn't they have everything they need (YES). I'm finally excited, keep me in your prayers.

The hospital where they will be doing the surgery (Duke). I'm not referring to the co-pays. How much was your deductible prior to surgery? And this info that you don't have to pay your deductible upfront came from someone that works for BCBS of NC.

I would continue to go forward with it. Just as Flipp said, she works for BCBS and they do not require you to pay the deductible upfront. It is totally up to the hospital, some will try and make you pay up front, hopefully mine will not. I'm going to move forward and pray for the best. I would listen to Flipp though as she works for BCBS.

My Dr is Sudan out of Duke. I already seen the nutritionist, and had my Psych eval, just waiting on approval from insurance co. Did you read the previous post from FLIPP, she's a bander here and she works for BCBS of NC and said that it's not required to pay the deductible upfront, but depends on what hospital you go to they might refuse surgery if you don't pay. I'm praying they can bill me, I'm really not in a position to pay the deductible upfront right now. I have a daughter who starts college in August and I have to be prepared to assist her. That will be more important than me getting this surgery. Don't get me wrong, this is definitely important, but college comes first.

I'm going to Duke, I'll just have to wait and see. Thank you for that info.

Congrats to you. I know I'm on Fiscal and my policy started over on July 1, 09. I'm glad you told me that I'm not required to pay my deductible upfront, but can they refuse my surgery if I don't pay upfront? I'm still waiting for BCBS approval, as far as I know, they sent my paperwork to them over a week ago. Just trying to be patient. Thank you so much for your input, it really help rest my anxiety a little. Keep up your good work and please update on your progress.

Good for you. I'm glad to hear that, maybe I still have hope. I'm just waiting on the approval from the insurance company. Being that our plan changed on July 1st, do you know if you have to pay the deductible up front? And who are you going through to get your surgery done?

Thanks. I would really appreciate that.