Insurance Authorization

[kheartskat 4]

Did anyone have certain guidelines to meet before getting approval for lap band surgery? I had my appointment with my surgeon and was ready to go, but my insurance requires 6 months of seeing a physician for review before approval -- So frustrating. I have gained 5lbs since my appointment a month ago. Feeling discouraged

[Colleen C 169]

It is all about your insurance for sure. Mine was really quick but from what I gathered from the dr's office that usually is not the case.

They did say something about co-morbilities (not sure of spelling) Anyway, I have high blood pressure and sleep apnea so there wasn't a problem.

I too would be disappointed to have to wait 6 months, I have heard some say a year. Ugh.

Try to stay positive, February will pop around before you know it. This weight loss is for sure a long process from square one to our goal weight. But, look what we get out of it! So much we have been longing for.

[NolansNana 210]

Hello, I had also had to have supervised weight loss appts for 6 months as well as a syche evaluation and appt with a dietition. Guess I spelled that right,anyway time flies. My surgery is on the 26th. Don't give up! Best of luck too you!

[NolansNana 210]

Hello, I had also had to have supervised weight loss appts for 6 months as well as a syche evaluation and appt with a dietition. Guess I spelled that right,anyway time flies. My surgery is on the 26th. Don't give up! Best of luck too you!

[The Icy One 518]

Did anyone have certain guidelines to meet before getting approval for lap band surgery? I had my appointment with my surgeon and was ready to go, but my insurance requires 6 months of seeing a physician for review before approval -- So frustrating. I have gained 5lbs since my appointment a month ago. Feeling discouraged

Oh, yeah. I had insurance hoops through which I had to jump. We all do. Those hoops vary by insurance company. My insurance company required four months of visits at my chosen practice, in my case, True Results, in Scottsdale, AZ. When I started I didn't really have to worry about my weight... In fact, I wasn't supposed to lose weight. My insurance company wanted my weight to stay within about five pounds up or down of my start point. I had to have medical documented proof of obesity going back three years (no problem, there! ), a couple of visits with a nutritionist at True Results, a consult with an exercise physiologist, labs, a breathing test and a psych eval. I was just healthy enough that I didn't need a sleep study. Not too bad, really. My practice did all of the heavy lifting and guided me through everything and made it effortless for me.

Ten days before the end of my four month hoop jump, my frakking insurance company threw me a curve ball and changed the rules and said that I had to be at or at least one pound BELOW my start weight to qualify for approval. Those sneaky S.O.B.s! So on top of everything else, I had to crash diet like a mad woman! And I did it. Squeaked in under the wire. Then I had to sweat out a five week wait for my approval phone call and letter. But I got them and my surgery.

All in all, the entire process took five months. I started on June 11, 2013 and I had my surgery on November 21, 2013.

When you are in the middle of it, it feels as if it is taking forever! As if the stupid hoops are never going to end, that your insurance company is going to torment you until the end of time and your surgery is off, somewhere in the far, distant ether. Then, all of a sudden your NP and Patient Advocate tell you that your hoops have all been jumped, your last test has been taken, they have collected the last bit of documentation and will be contacting your insurance company and will call you as soon as your approval comes back and sit tight and wait for the call.

Hang in there. This too, shall pass. You will be on the other side, before you know it.

Edited June 18, 2014 by The Icy One

[betty_s 476]

Mine was 12 months, so maybe you can look on the bright side and appreciate that it could be twice as long? haha its all worth it. 3-6 months supervised seems to be the norm around here.

[The Icy One 518]

Mine was 12 months, so maybe you can look on the bright side and appreciate that it could be twice as long? haha its all worth it. 3-6 months supervised seems to be the norm around here.

12 months? I'd have gone out of my ever loving mind! I thought five, start to finish was bad. I admire your fortitude!

[betty_s 476]

Haha it took a lot of patience. Luckily it wasn't a supervised diet or anything, it was just monthly phone calls with a health coach. 12 very long months of phone calls!

Mine was 12 months, so maybe you can look on the bright side and appreciate that it could be twice as long? haha its all worth it. 3-6 months supervised seems to be the norm around here.

12 months? I'd have gone out of my ever loving mind! I thought five, start to finish was bad. I admire your fortitude!