Approval Seems A Bit Too Easy.

[kymie9899 37]

My rep sent me the requirements for my insurance in writing which is great. I now have a major concern though. She sent me a list of surgeons and website where I can view their requirements. I read that they will want a letter of medial necessity from my Primary Care physician and I do not have one. I have always gone straight to the Dr that I know can fix the issue. For my PsuedoTumor Cerebri I have a neurologist, for my fertility problems I have an OBGYN, for my back problems a chiro. I have never went to a primary care physician for my weight because my neurologist said they would just subscribe pills and told me to do WW, which I did many times as well as the HCG diet and many other fad/crash diets. I can get a Primary care physician if they want just hoping this doeskin derail me.

I had a PCP who hates the thought of WLS, my surgeon did everything for me and said your PCP is required to to the necessary presurgical tests. I went this week and had no problem, and surprisingly my PCP was nicer when she saw that I don't need her opinion to get what I know I need done. I think if you get the records ( I know I did) from all your different doctors or specialists these can be used as they will show a history of problems and comorbidities.

[KryssieWantsHerBand 0]

My rep sent me the requirements for my insurance in writing which is great. I now have a major concern though. She sent me a list of surgeons and website where I can view their requirements. I read that they will want a letter of medial necessity from my Primary Care physician and I do not have one. I have always gone straight to the Dr that I know can fix the issue. For my PsuedoTumor Cerebri I have a neurologist, for my fertility problems I have an OBGYN, for my back problems a chiro. I have never went to a primary care physician for my weight because my neurologist said they would just subscribe pills and told me to do WW, which I did many times as well as the HCG diet and many other fad/crash diets. I can get a Primary care physician if they want just hoping this doeskin derail me.

Hey tsteves1,

I actually work for Wells Fargo as well and having the same concern... I have never really had a PCP.. I just went to whoever could fix my issue and for emergencies, an urgent care/ER. My question is .. What did you end up doing in your case? Also, other than the letter from your PCP.. What else was a necessity from UHC before you got your LB?

Thanks for the help!

[rellsimpson 4]

As long as you can provide documentation from a dr stating your weight throughout the years it doesn't matter if they are your pcp or ob doc or any other soc for that matter. My insurance (BCBS Fed) had the same requirement and I submitted office notes from my weigh ins from my ob doc. and I was approve.

[Shannon51 0]

I haven't been banded yet, my surgery date is March 16th. My only requirements were a BMI of 40 or more also with the typical psych eval. I was anxious and wondering if this was correct...and yes in fact it was. My approval took 6 days and now I'm being banded next week. Don't let everyone else's insurance horror stories worry you to much, I did and I worried for nothing. When in doubt call your benefits dept to double check everything! Every insurance company's requirements are different and every state is ran individually for example I have blue cross blue shield of illinois and my cousin has bcbs of arizona...we have entirely different requirements then eachother. Best of luck to you

[brownie012 1]

I thought it was a little too easy as well. I pulled up BCBS requirements. Went down the list, did psych eval, nutritionist to make sure i understood the after-diet. Typed letters of emotional support from family, got mwdical records proving weight 2 years back, made a list of diets for the nutritionist. got pcp (who is actually internal medicine specializing in respiratory) to sign a letter of necessity. Sent bcbs a copy of blood panel showing no thyroid problems. Got approved same day it was sent in. Had surgery 2 weeks ago. down 15.5lbs!

[brownie012 1]

I thought it was a little too easy as well. I pulled up BCBS requirements. Went down the list, did psych eval, nutritionist to make sure i understood the after-diet. Typed letters of emotional support from family, got mwdical records proving weight 2 years back, made a list of diets for the nutritionist. got pcp (who is actually internal medicine specializing in respiratory) to sign a letter of necessity. Sent bcbs a copy of blood panel showing no thyroid problems. Got approved same day it was sent in. Had surgery 2 weeks ago. down 15.5lbs!

[tsteves1 14]

Hey tsteves1,

I actually work for Wells Fargo as well and having the same concern... I have never really had a PCP.. I just went to whoever could fix my issue and for emergencies, an urgent care/ER. My question is .. What did you end up doing in your case? Also, other than the letter from your PCP.. What else was a necessity from UHC before you got your LB?

Thanks for the help!

I ended up not having to have anything from a PCP. They took my word that I have been overweight at least 5 years and the approval was still very easy. I have my psych eval and promised to keep in contact with my bariatric case worker as well as my behavioral health case worker and got a first letter approval! I was psyched and I am banded!

[KryssieWantsHerBand 0]

I ended up not having to have anything from a PCP. They took my word that I have been overweight at least 5 years and the approval was still very easy. I have my psych eval and promised to keep in contact with my bariatric case worker as well as my behavioral health case worker and got a first letter approval! I was psyched and I am banded!

Woah, Thanks! Keep us updated!

[Diane515 0]

I haven't had such luck! My Endocrinologist seems to think that I just need more determination and motivation and everything will be great...I don't need surgery. Ya...I look at food and gain weight! I'm going to my primary physician on Friday. I'm soo frustrated - I have a 38 bmi with all kinds of health issues!

[Diane515 0]

I haven't had such luck! My Endocrinologist seems to think that I just need more determination and motivation and everything will be great...I don't need surgery. Ya...I look at food and gain weight! I'm going to my primary physician on Friday. I'm soo frustrated - I have a 38 bmi with all kinds of health issues!