Bmi 38 - Dr. Enochs In Cary, Nc

[NCHope 0]

I go for my first appt. tomorrow. My ins. will pay if BMI is 40 or higher or 35 with issues. Has anyone been to Dr. Enochs and been BMI of 35-38 and had ins. pay? How did the doctors office help you with getting ins. to pay?

thanks!

[Jean McMillan 2,973]

Insurance approval will depend on the terms of your particular policy. Call the insurance company and ask for the weight loss surgery coverage terms for your own policy.

Most surgeons have an insurance coordinator who helps patients determine what requirements each patient has to meet in order for their policy to cover pre-op tests & evaluation, the surgery, and fills or aftercare visits.

For input about Dr. Enoch and his/her staff, you might get more responses if you post your question here:

http://www.lapbandtalk.com/forum/47-north-carolina-local-lap-band-support/

[DaniGurl87 4]

My Doctor is Dr.Enochs and yes depends on your insurance company I have BCBSof NC- my insurance wanted 3 years previous with BMI of 40 or up- I had 2 years 40bmi and 1 year 38bmi... they denied the first time but Dr.enochs office sent in pictures of myself and explanation of why it would benefit my health in the future and they approved the second time. But it all depends on your insurance company and what they want.. Some insurance companies only want your current year bmi. Hope this helps and good luck!

[NCHope 0]

Bratt1345,

Just read your response. I have bcbs athem. I have their policy printed out on weight loss surgery and it doesn't say that they need a history, which I don't really have. So now I am concerened that this will hold up the process. Did you read your policy and it said that or was that something they just came back with? thanks

Also seeing Dr. Enochs - Sleeve.

[DaniGurl87 4]

Yes- I brought up my insurance policy on the bcbsnc.com website and logged in with my information and this information was in my breakdown of codes and procedures that were covered and these were the specific requirements. No if you were under bmi40 and had 2 comorbids - you were eligible without the history.. But I also called the insurance company and dr.enochs insurance coordinator helped me.

[NCHope 0]

Oh I see you are bcbsnc, I am bcbs athem. They only require 1 co-morbidity under 40bmi. I have sleep apnea. Hope everything goes well with your surgery!

[losingit919 13]

Oh I see you are bcbsnc' date=' I am bcbs athem. They only require 1 co-morbidity under 40bmi. I have sleep apnea. Hope everything goes well with your surgery![/quote']

Good luck! I had mine done with Dr Moran's office at Raleigh Center for weigh loss surgery. (REX). They are awesome. I have the same insurance as you and was approved with the first submission. I had low BMI with a comorbity. When you fill out your paperwork you will need to recall all of the times you have tried to diet, exercise, ect. They will request medical records that document your weight.

[AlmaD 9]

my bmi is 38 and my insurance approved my surgery ..I have united healthcare and they had me go thru 6 months of monthly weigh in with my pcp. soon to be banded in two weeks