Savedbygrace 11 Posted January 26, 2008 These post are the first time i've heard of BC requiring a pt eval?? I printed the policy guidelines and its not mentioned. Is it new? I'm sure they don't pay for it. What all is involved? Share this post Link to post Share on other sites
andyisbanned 1 Posted January 26, 2008 These post are the first time i've heard of BC requiring a pt eval?? I printed the policy guidelines and its not mentioned. Is it new? I'm sure they don't pay for it. What all is involved? I did not have to pay any co-pay. I spent an hour or so going over the different exercises I will be required to do at home as part of my surgery. I don't know if everyone has to complete a PT eval. I know some people have to have a Psyhc eval. I did not have too. I guess it is a little different according to your plan. Share this post Link to post Share on other sites
sharpei in process 0 Posted January 27, 2008 HEY, WELL I PLAN TO USE ANDREW DEWITT IN B'HAM..I KNOW SEVERAL WHO HAVE USED HIM FOR GASTRIC BYPASS....HE HAS DONE MANY lAP BANDS..I THINKS HE TAUGHT DR.BILLTON HOW...YOU MAY NEED A COUPLE OF FILLS BEFORE YOU ARE RESTRICTED ENOUGH FOR SIGNIFICANT WT LOSS...MOST SAY IT TAKE ABOUT 3 FILLS TO BE RESTRICTED ENOUGH..... I CK.'D WITH DR BILLTONS OFFICE 2 YRS AGO.FOR GASTRIS BYPASS...AT THAT TIME THEY TOLD ME I DID NOT MEET CRITERIA....I HAVE ALWAYS WANTING THE LAP BAND...AND DESIDED TO WAIT UNTIL THE INSURANCE STARTED APPROVING IT....I KNEW IT WOULD ONLY BE A MATTER OF TIME.. IT IS SO MUCH LESS INVASIVE THAN GB....I AM A NURSE AND WORKED IN HOSPITAL WHEN DR. DEWITT WAS A SURGEON AT CARRAWAY BESSEMER. GOOD LUCK!! i DO CARE FOR DCH AND THE WAY IT IS RUN...SO I WILL GO TO B'HAM,WHEN I HAVE A CHOICE. EMERGENCY...I MAY HAVE TO USE DCH. ELAINE WHEAT Share this post Link to post Share on other sites
sharpei in process 0 Posted January 27, 2008 HEY, WELL I PLAN TO USE ANDREW DEWITT IN B'HAM..I KNOW SEVERAL WHO HAVE USED HIM FOR GASTRIC BYPASS....HE HAS DONE MANY lAP BANDS..I THINKS HE TAUGHT DR.BILLTON HOW...YOU MAY NEED A COUPLE OF FILLS BEFORE YOU ARE RESTRICTED ENOUGH FOR SIGNIFICANT WT LOSS...MOST SAY IT TAKE ABOUT 3 FILLS TO BE RESTRICTED ENOUGH..... I CK.'D WITH DR BILLTONS OFFICE 2 YRS AGO.FOR GASTRIS BYPASS...AT THAT TIME THEY TOLD ME I DID NOT MEET CRITERIA....I HAVE ALWAYS WANTING THE LAP BAND...AND DESIDED TO WAIT UNTIL THE INSURANCE STARTED APPROVING IT....I KNEW IT WOULD ONLY BE A MATTER OF TIME.. IT IS SO MUCH LESS INVASIVE THAN GB....I AM A NURSE AND WORKED IN HOSPITAL WHEN DR. DEWITT WAS A SURGEON AT CARRAWAY BESSEMER. GOOD LUCK!! i DO NOT CARE FOR DCH AND THE WAY IT IS RUN...SO I WILL GO TO B'HAM,WHEN I HAVE A CHOICE. EMERGENCY...I MAY HAVE TO USE DCH. ELAINE WHEAT Share this post Link to post Share on other sites
sharpei in process 0 Posted January 27, 2008 Some BCBS policies do not require a 6 month monitored diet program, but the state of alabama employee's BCBS does require the 6 mo plan..which what i had to do. Your Dr. office deals with them and can inform you...best to call the 1800 no on back of your card and ck your self... at the semminar I thought i did not have to..but it proved wrong...elaine Share this post Link to post Share on other sites
heather113076 0 Posted January 27, 2008 Andy~ Congrats on approval!! :wink2: How long was it from when your surgeon submitted the paperwork to when you got the approval? I am 2 1/2 months into my 6 month required diet. I have already done the seminar and support groups, I have to do the sleep study on Feb 11 and have not yet scheduled my psych evaluation which I will schedule tomorrow. My surgeon told me that I will have to do the nutrition class/surgery prep class(one class for both subjects) but I cant schedule that until I have my surgery date. I hope to be banded in June or July. Share this post Link to post Share on other sites
andyisbanned 1 Posted January 28, 2008 Heather: It was only an hour with online submission. You will do it. Share this post Link to post Share on other sites
andyisbanned 1 Posted January 28, 2008 Sharpei: I have not found any BCBS policy that let's you skip the 6 month doctor directed deit. According to my surgeon's office, BCBS requires this for all of their insurees no matter the plan. This is their policy for any weight loss surgery as of 2006. Share this post Link to post Share on other sites
sharpei in process 0 Posted January 28, 2008 not pt eval....6 month diet program prior to Lap band approval Share this post Link to post Share on other sites
sharpei in process 0 Posted January 28, 2008 we had to do PT,Nutrition,psych,evals...had to pay for up front...may or maynot get some reinburstment Share this post Link to post Share on other sites
Rocket City Guy 0 Posted January 28, 2008 Sharpei: I have not found any BCBS policy that let's you skip the 6 month doctor directed deit. According to my surgeon's office, BCBS requires this for all of their insurees no matter the plan. This is their policy for any weight loss surgery as of 2006. Andy, Federal BCBS does not require a 6 month diet. In fact, getting approval from Federal BCBS was easier than all of the things the doctor required for me to do such as sleep study (which has added at least 3 months to my wait time). Share this post Link to post Share on other sites
Rocket City Guy 0 Posted January 28, 2008 I guess I kinda got ahead of myself, commenting to Andy before introducing myself.... I live in Huntsville, AL and am being banded on 22 Feb by Dr. Schmitt in B'ham. I started this process back in August (seminar), had my first appt with Dr. Schmitt on 25 Sept, was approved by FED BCBS in October, and finally got through with all the sleep ap related stuff in late december, and got my surgery date a couple of weeks ago. It's really inspiring to read how everyone is doing...and was even more inspiring to hear Tammi talk at the support group I attended. Share this post Link to post Share on other sites
andyisbanned 1 Posted January 29, 2008 Okay. I don't know everything. Federal BCBS is evidently different. I can only speak of my experience and what I have been told by others. :tt1: Share this post Link to post Share on other sites
andyisbanned 1 Posted January 29, 2008 I received my surgery date today. I will get the Lap-Band on February 14, 2008. What a valentine's day gift to myself! I cannot wait. :tt1: Yeah!!!!!:frown: Share this post Link to post Share on other sites
glorybee123 0 Posted January 29, 2008 Congrats on your surgery date! Hope all goes well! Share this post Link to post Share on other sites