HELP!! six month supervised weightloss

[JamieBaby1105 0]

Hi all I'm new here and really need some help. I have done everything-EVERYthing to get approved for the lapband and my doctor assured me we had the six months of documentation needed. However when he gathered information we realized I missed a month. I have see him ten times in the past year and eight of those times fall in the six months. The dates are:

7/16

7/23

8/20

9/24

I DONT KNOW HOW I MISSED OCTOBER!!! :bored:

11/16

12/29

1/9

1/29

Do you think they will deny me because of the missed month? :glare:

I am a teacher and really need the surgery to fall in the summer and if I start over it has to be from April 20 (I thought I was done and my RTC was 3 months) and thus would be unable to schedule surgery till October and could not take the time off work. :sleep:

I have GHI insurance

Edited May 7, 2010 by JamieBaby1105

[crecia1975 4]

It all depends on your insurance company. I have Cigna and I know they are very, very strict about the 6 months being in a row. My doctor stressed that point with me, when I scheduled all of my appointments. It won't hurt to call your insurance company and see what they have to say. They may be ok with the missed month. I hope this works out for you. My mother is a teacher and I know how hard it is to get time off of work. Good luck to you. I will pray for your approval!:bored:

[JamieBaby1105 0]

Thank you Crecia. I called GHI today and they said that it was really up to BCBS (my hospital provider) and the woman I spoke to did not seem to think it was a huge deal but who knows. :thumbup: I called the surgeons office and spoke to one woman who said that since I went 8 times in 6 months they might overlook the fact that I missed a calender month- She said that people usually get denied when they have 3 or 5 visits. She transfered me to the person who deals directly with the insurance and I left a message.

I think I'm going to write a letter about the fact that I have no problem with the six month requirement and that missing the appointment was due to circumstances beyond my control and in fact will have a second six month completed in September--but NEED to have the surgery sooner- I really want to be 100% healed and on track when I go back to school. Doing it in early July will help because I have NOTHING else schedule in the summer and can get on track with diet and exercise--I can devote my summer to becoming accustomed to the band. So it's really a matter of if they are going to be sticklers.

The six month requirement is kinda silly in a way because research shows that a six month monitored weightloss is not sustainable but insurance companies do it a "trial run" to make sure you can keep appointments and that you are commited. Im a teacher--in New York City. I have my Master's degree. I would say I know a thing or two about commitment--I could teach Commitment 101. I have never once set a goal that I have been unable to reach--well except this weightloss thing:blush: lol. but I need the tools to do it.

Maybe I'm worried for nothing but a denial would really throw a monkey wrench in my plans. :thumbup:

Im gonna stop ranting but would appreciate any feedback or advice.

[JamieBaby1105 0]

GREAT NEWS!!! :thumbup:I got a call from the doctor's office today and she said that with documentation from the 8 visits I would have NO PROBLEM getting approved!! I have my final visits Thursday (PCP, chest x-ray and psych) and then once the forms are faxed I'm good!! :thumbup:

Such a relief! I am anticipating an approval by the first week in June and will take the first date they have available after June 28th (last day of school). :thumbup:

Next Hurdle: Pre Op Diet!!

[crecia1975 4]

Woo Hoo! That is so great. I'm so happy for you. :smile2:

Please let us know how everything goes.