Anyone from Rochester, NY?

[petra1124 33]

My BCBS is out of South Carolina, and as much as my PCP did know and note that I have tried many weight loss regimes I did not weigh in with my PCP at the same time and get a "write up and evaluation" each time, each month for six months straight. I have my PCP note about my weight loss attempts, 8 years of my weight records and pretty much very doctors records that weighed me and I have been told this is a done deal and they won't accept anything but me going back to the drs and getting weighed and evaluated by the nutritionist for 6 more months. This is happening to a few people who work for my company that are going for the procedure. It took the doctors office by surprise I think, or are least I HOPE so and they didn't just get lazy and not check. I am trying to be as pleasant as possible to the ladies there but really just want to flip a table.

I hope this is not the case for me...as I dont think i saw her every month when i was on weight watchers... but I have seen the nut the last 2 months in a row...so worst case scenerio I would have to see her 4 more months.

[Nicole 2013 44]

Congrats on being post op.. How are you feeling?

I feel wonderful ready to go back to work I'm happy I had it done no regrets... Dr Gandhi and his team were great

[SkinnyRicki 34]

Hello rochester peeps!! Glad to see some neighbors! I am almost 2 months out! Which is hard to believe.... It took me forever to get approved and now the time since surgery has almost flown by! I had my surgery with Dr O'malley at highland and I loved highland, they were great!

[petra1124 33]

Hello rochester peeps!! Glad to see some neighbors! I am almost 2 months out! Which is hard to believe.... It took me forever to get approved and now the time since surgery has almost flown by! I had my surgery with Dr O'malley at highland and I loved highland, they were great!

I remember us chatting once, but I forget if you told me what insurance you have....what kind of issues did you encounter when getting approved. I am meeting Dr. OMalley tomorrow and I am a nervous wreck about insurance!!!

[petra1124 33]

I have Excellus BCBS by the way......

[SkinnyRicki 34]

I started out with MVP, and that was what caused all the issues, I was denied a few times and appealed and was still denied, so I ended up waiting until the new year and switching to excellus bc/bs, and I was approved right away and was able to schedule my surgery in 3 weeks! I couldn't even believe it at first because of all the crap I had already gone through with MVP. Bc/bs was much nicer all around, and the only thing I have had to pay we're copays. I also wanted a private room in the hospital so I paid for that but it was worth it!

[petra1124 33]

I started out with MVP, and that was what caused all the issues, I was denied a few times and appealed and was still denied, so I ended up waiting until the new year and switching to excellus bc/bs, and I was approved right away and was able to schedule my surgery in 3 weeks! I couldn't even believe it at first because of all the crap I had already gone through with MVP. Bc/bs was much nicer all around, and the only thing I have had to pay we're copays. I also wanted a private room in the hospital so I paid for that but it was worth it!

Did BCBS want extra documentation from your PCP or were they happy with what Highland gave them. I have my first appointment with Dr. Omalley tomorrow and I am just wondering what to expect. I was told that they would be scheduling my surgery tomorrow, but how can they do that if it hasnt been submitted to insurance yet?! Do you know what info is sent over to insurance? Any insight would be great...I am SO anxious right now!

[pandabear 39]

Did BCBS want extra documentation from your PCP or were they happy with what Highland gave them. I have my first appointment with Dr. Omalley tomorrow and I am just wondering what to expect. I was told that they would be scheduling my surgery tomorrow' date=' but how can they do that if it hasnt been submitted to insurance yet?! Do you know what info is sent over to insurance? Any insight would be great...I am SO anxious right now![/quote']

I had all of my appointments right down to post op appointments scheduled. I think they need a general date to submit. One of the things that one of my phone calls did bring to light is that you can call the line for pre authorization and ask your questions. My problems was I just called customer service and got the generals of my policy that didn't go into the nitty gritty, they save that stuff for pre auth. All BCBS policies are different, so yours might be more forgiving than mine, and I wish you the best of luck. But best, call pre auth and talk to someone.. (Mind you I have called my case nurse three times with no luck at even talking to someone.. But I feel like I am at least being proactive.)

[petra1124 33]

Well I got my surgery date today (April 24)! They will be submitting to insurance next week but my Dr said he doesn't forsee any complications as I have 2 comorbidities... I am super excited and anxious! I think it will reel more real once I've been approved.

[Nicole 2013 44]

Well I got my surgery date today (April 24)! They will be submitting to insurance next week but my Dr said he doesn't forsee any complications as I have 2 comorbidities... I am super excited and anxious! I think it will reel more real once I've been approved.

Congrats

[SkinnyRicki 34]

Did BCBS want extra documentation from your PCP or were they happy with what Highland gave them. I have my first appointment with Dr. Omalley tomorrow and I am just wondering what to expect. I was told that they would be scheduling my surgery tomorrow' date=' but how can they do that if it hasnt been submitted to insurance yet?! Do you know what info is sent over to insurance? Any insight would be great...I am SO anxious right now![/quote']

They were fine with what highland sent them, I had already done the 3 months of mandatory nut visits and they approved it fairly quickly. I had no comorbidities but my bmi was high enough to meet their specifications

[petra1124 33]

My primary dr is the one who wrote letter saying I had done 6 months of diets i was approved quickly with Dr.Gandhi through RGH I'm.now 1 week post op.

What insurance do you have? Are you 40> bmi? I am 36 BMI... I have Excellus BCBS and I am a nervous wreck right now!! I got my surgery date today...but I cant stop thinking about getting my insurance approval!! AND they wont be submitting till next week!! The doctor said that he doesn't think there should be any issues since I have 2 co-morbidities, but I am just so nervous they wont accept my PCP write off of the 6 months of dieting I did. I never saw my dr each month that I did weight watchers, nor did she document each month. She just knows me and knew I was on it, so all I had to do was write the diets Ive done on this form and she signed off on it. I'm so scared to be so close just to have to do 4 more months of nut appointments! I think I might go crazy by the end of next week ....starting to obsess just a lil...

[GFERRELL 1]

Im from rochester im having dr gandhi at rgh do my surgery im scheduled for march 20th

Hi Nicole, I also had dr Gandhi and had my surgery on 3/27? I feel great. How has it been for you? Gayla

[Nicole 2013 44]

Hi Nicole' date=' I also had dr Gandhi and had my surgery on 3/27? I feel great. How has it been for you? Gayla

[/quote']

Im doing great how are you doing? Hes a wonderful dr

[GFERRELL 1]

I'm from Rochester having my surgery at Rochester General by dr. Gandhi on march 6th

Hi, my name is Gayla. I had my surgery with dr Gandhi on march 27. I feel great 6 days out. How are you doing?