Aproved At Last~~B.C.B.S. Of New Jersey`

[Chris1982 2]

Hello everyone I'm sure some of you are familiar with some of my threads, like the one last week were I said I had about given up. Well great news today I was told by my insurance today that I was elligable to go through with the lap band surgery, well I'm an ol country boy so I said "So by elligable you mean approved rite?" And he said yes I was aproved and I could go ahead and make preperations to have the lap band procedure, its been a long stugle but finally here I am. Time for band land lol. My first info was submitted to insurance in august so hang in there all you who are waiting and good luck!

[TracyinKS 7]

CONGRATULATIONS!!!!!!!!!!!!!!!!!!!!!!!!

[johnr441 0]

Huber,

I was just told by BCBS that I was too big for Lapband (my surgery was schedualed for Monday) My BMI is 50+ and they said it needed to be around 40. I would have to lose 100 lbs to get my surgery to lose the other 100, They will approve Bypass. I do not want to be pushed to major surgery but I do not want to stay big. How fast was your reply after your appeal and how did you appeal?

[Lap_dancer 8]

I'm dealing with BCBS of FL right now. OMG...urgh.

[Chris1982 2]

I didn't apeal I've just been patient and been calling them once a week and I finally got approved I guess my doctors letters are just very persuasive.

[GayleTX 1]

John....you need to call back and talk to a supervisor, not a clerk .......40 is the minimum, not the only number acceptable!! BCBS did mine and I had a BMI of 62.

[Alexandra 55]

John, your BMI may put you outside of their recommended guidelines for approving patients, but that doesn't mean the door is closed. You and your doctor need to come up with reasons why banding is a better medical choice for you than bypass--make the medical case for it and you'll likely get that denial overturned.

Initial decisions at insurance companies are made by fiat, by hard-and-fast guidelines read essentially by people thinking like computers. Just take it to the next step and ask for a medical review, and you'll get to a human being thinking like a doctor. Good luck!!

Huberslave, CONGRATULATIONS!!! Patience pays off, and I'll bet you're better prepared now for surgery and all it entails than you were back in August. I went through a similar wait time--even longer, actually--and in retrospect I'm glad I did. Good luck with your surgery!!

[Chris1982 2]

Thanks yes I guess I'm prepared its just alot going on this month to get to surgery all I am lacking is setting up an appt. with the hostpital to have blood drawn ekg and all that good stuff everything else is in place so I'm hoping my hostpital calls soon so I can get that scheduled and took care of.