8675309 0 Posted May 3, 2007 My BP is running 190/150 with meds and I am just tired of all of this. I called my insurance company and they said WLS was excluded. When I pressed they said it is occasionally approved because of medical necessity. I weigh a little over 200 and am an incredibly small framed 5' 0" woman. I was planning on trying to self-pay with Kirshenbaum, but really don't want to wait if there is any way I can the surgery approved through my insurance. Also, since I am a teacher, summer is the only time I can get this surgery. Which doctors in Texas are good docs and good about submitting the paperwork that gets approval. Thanks in advance. Share this post Link to post Share on other sites
thelapbandduo 0 Posted May 4, 2007 My husband and I used DR, KUHN at the WLS at Baylor, and have loved every bit of this. I was just banded on 4/30 but he was banded on 4/9 and have had no problems. I work for a health insurance company and have had several people ask for help. I would say the first thing you need to do it call them and find out why they need to prove the medical ness. for this type of surgery. some times its as little as a letter from you primary care and other times as with my insurance its a 6 to 12 month diet plan that you have done with your doctor. 5 year history of morbid obesity, a bmi over 40 or 35 with comorbidities and and phsych eval. Whatever its is don't give up. We had to fight for almost a year to get approved and like I said I work for the dang insurance. Share this post Link to post Share on other sites
8675309 0 Posted May 7, 2007 Thank you. Does anybody else have any recommendations? Share this post Link to post Share on other sites