jessress87

Hey all! I've taken another step in my journey! So far things have gone very smoothly (although I'm still in the very beginning!) 10/02/09 PCP referal to Bariatric Surgeon. 10/13/09 WLS Seminar at Surgeon's office. Next... 10/20/09 1st Appt (H&P) with Surgeon Psychaitric evaluation PCP to start three-month diet (I'm running low on vacation time so I'm trying to squeeze as much into a day as possible! My question now is: For the three-month supervised diet, does that literally mean 90 days or does it mean one visit a month for three months? My insurance literature doesn't specify and I haven't had much luck with the BCBSIL reps over the phone. Has anyone else done this? Just a side note- my Surgeons office has been great! They handed out a packet with just information about the process and procedures and a second packet with all the forms that need to be filled out before my 1st visit. In that packet they include a chart for me to give to my PCP to track my three-month diet so we know we're recording all the info they will need at the insurance company Awesome!

I'm in the process of filling out my packet for the Surgeon's office and one of the things that it tells me to do is include a letter of medical necessity, it says 'A letter of medical necessity that is typed or neatly written by you explaining why you feel it is medically necessary for you to have surgery.' I know that my surgeon is going to be writing one for the insurance company also but apparently they need me to write one too. Has anyone else had to do this? I've found a couple examples on line but I was hoping to hear from someone with experience. Thanks!

Hi TinaM! Just wanted to wish you luck on the rest of your journey :thumbup: I've gone through something similar as far as the office pictures. I work as a customer service rep in a small call center. Last Christmas our supervisors decided to have a group picture taken to send out to our clients- I was horrified! I strategically took my lunch break during the time that the picture was being taken and somehow my supervisor knew that I was sitting in my car in the parking lot and she came out and got me! Now I feel self-conscious whenever I get a call from someone I think has seen the photo- it sucks! I too am on my way to getting the Lap-Band and I'm really excited. So far I've been the a Seminar, got all my paperwork to fill out and am meeting with my Surgeon Tuesday, followed by my psychiatric evaluation later that morning and then an appointment with my PCP that afternoon to get my three-month supervised diet going. Best of luck!!

Good for you for taking the first step! I too am in the very beginning stages and a lot of what you said reminds me of myself, I've avoided pictures and mirrors so I wouldn't have to accept it- that only works for so long. Also, my PCP is very laid back about my weight to- he's never brought it up and my BMI is 48! My Seminar is tomorrow and I am very excited- good luck on your journey!

Hi All! One of BCBS of IL's requirements for insurance approval is a 24 month history of weight loss attempts with results (that is my understanding of it, anyhow. I requested a list of requirements from BCBS a week ago today and still haven't gotten anything, I'll be calling them later). Has anyone else had to do this? What format did you use for the 24 month diet history? I'd like to go ahead and get a rough copy started so I can work on finalizing it. I want to make this process as smooth and quick as possible!

My understanding is that they want a record of my weight loss attemps from the previous 24 months, not a supervised diet for the next 24 months (I hope not, at least!)

Thanks for all the info! I actually live in Ohio, I'm not sure which yet but it's going to be either Dr. Clarey or Dr. Bruce in Dayton.

Yowie! $100 is a pretty penny, but I reckon it's worth it :thumbup:. How often are fills typically? I've not stumbled on that bit of info yet.

Do you mind if I ask you if your pre-op care was covered and if you know if the fills and post-op care are covered?

I did some checking and I found out that the facility where I am planning on having my procedure is a 'Blue Distinction Center for Bariatric Surgery' although I'm not 100% sure what that means, sounds good though Thank you so much for the input, everything that anyone has to say is so precious to me right now- I'm just soaking it all up!

I am at the very beginning of the whole process and I am just going nuts! Last Friday my PCP faxed my information over to my local lap-band surgeon, yesterday they signed me up for an informational seminar for Tuesday 10/13. I called my insurance company (Blue Cross Blue Shield of Illinois) yesteday and found out that my company does NOT exclude bariatric surgery (YAY!!!) but there is a whole mess of criteria I have to meet (which is to be expected), however, one of the criterion has got me in a panic. While the BCBSIL rep was listing the requirements she mentioned documented weight loss attempts and results for the past 24 months. I've been severly overweight for the last five years or so but I don't really have any doctors records of weight loss attempts. About this time last year I went to my PCP about my weight and they set me up on a diet plan and prescribed me Adipex, unfortunately I didn't follow up. Does this mean that I'll have to wait 24 more months before I can have the surgery? I see that most people with BCBS had to do 6 months supervised diet, which is fine with me- I think it would be torture to have to wait two years though! I'm so excited about this procedure, I want to get my life back on track! Does anyone have any input about the 24 months thing??

You don't know how relieved I am to hear that someone with the same insurance as me has been successfully banded! I've been going to the same doctor practically since I was a kid (I'm 22, still technically a kid if you ask me!). I've been to the office several times in the past few months and I'm sure a time or two before that in the past 24 months but the only time I remember them weighing me was at my appointment last week when he referred me to the surgeon and last year, probably around July when I went to see about a weight loss regimen. Hopefully that will do!

Thanks for your support everyone! I'm feeling more confident already. I decided to get a journal and log all my steps in the process, it helps me feel more organized about the whole thing. I'm willing to wait as long as I have to to get this done but it would be great to get it sooner rather than later.