tommygirl 0 Posted June 28, 2006 Hi, I went to the Doctor at the weight management center today, he said I am a great candidate for lapband and my bmi should qualify me no problem for insurance, my question is: does the surgeon (first appt. with him is 7/18/06) get me approved right away or do they wait for all of the pre-op requirements to be met?? The reason I ask is that my insurance, bcbs of ma, is changing it' s policy on wls requirements as of 2007, so I wanted to be prequalified now, because I know realistically it could take until after the first of the year to be done with all the tests, nutritionists, etc. Any input?? THANKS!!! Kristin:p Share this post Link to post Share on other sites
Time to love me 0 Posted June 28, 2006 Hi, I went to the Doctor at the weight management center today, he said I am a great candidate for lapband and my bmi should qualify me no problem for insurance, my question is: does the surgeon (first appt. with him is 7/18/06) get me approved right away or do they wait for all of the pre-op requirements to be met?? The reason I ask is that my insurance, bcbs of ma, is changing it' s policy on wls requirements as of 2007, so I wanted to be prequalified now, because I know realistically it could take until after the first of the year to be done with all the tests, nutritionists, etc. Any input?? THANKS!!! Kristin:p My surgeon put in the paperwork for me 2 days after he gave me a date (he was waiting for his PA to come in from a seminar), It's been about a week and half and I've not heard anything yet. I went to Lahey in Burlington, MA and I love how they do their appts. They schedule one day from 9-4 and you see the psych., PA whom gave me an exam, nutritionist and you have your lapband info. class. Then I went to 2 nutritionist appt. and was giving a date, I had to post pone due to a sick family member. I also heard BCBS was changing their policy, I know they have chaged some things since April of this year and they are doing more further down the line. My best suggestion is for you to ask to be put on waiting lists, even though you have an appt. A lot of stuff happens and may not go someone's way.. so they cancel their appts. I was not suppose to see my surgeon again until Aug. 18th.. and boom two days later they had someone cancel and I got in and came home with a surgery date. Everyone's experineces are going to be different, I think, because no hospital or surgeon is the same. Best of luck and let us know how it all fares out for you. Share this post Link to post Share on other sites
juliegeraci 7 Posted June 28, 2006 It depends on the insurance. I was able to get surgery with the BMI at 40%. Some insurances want you to lose X amout of weight or go through some pre studies. Once I hit the BMI ration I was submitted and approved when I had my surgery date in about 2 weeks. I have United Healthcare and had to use the "out of network" feature. Share this post Link to post Share on other sites
wantlapband 0 Posted July 21, 2006 I didnt' know BCBS is changing its policy on WLS in 2007....I am waiting for approval..my date is set for september 20th..I think I will start calling the insurance company. I'm nervous Share this post Link to post Share on other sites
sleepyjean 0 Posted July 21, 2006 I have blue cross and they wouldn't submit anything to insurance until all of the pre-op stuff was done. I had to wait an extra 3 weeks for them to submit my stuff because the nutritionist couldn't see me until then! Share this post Link to post Share on other sites
Time to love me 0 Posted July 22, 2006 Just to update.. I got my approval a day after I posted my last post. It took me just under 3 months from start to finish to be approved. Like i said, it was great because my first appt. was a day long process from 9-4 and I got to see everyone that I needed to see in one day. Then I lost ten pounds within one months time, the nutritionist gave me an appt with the Dr. 2 days later, along with my temp. surgery date.. pending insurance approval and boom i was approved within 2 weeks. I will be banded on July 27,2006 Share this post Link to post Share on other sites
wantlapband 0 Posted July 22, 2006 yeah!! That is so soon! I am so happy for you!! I haven't heard anything yet. My first appt for testing is on August 3rd, the whole day. It would be a waste if I didn't get approved. I wonder what kind of team the insurance companies have to make their final decisions for surgery. Share this post Link to post Share on other sites
wantlapband 0 Posted July 22, 2006 oh, I have a surgery date, do you think that will make a difference to the insurance company when they see i have a date set?? Share this post Link to post Share on other sites