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How long was your process?



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I have BCBSIL and they only require a psych evaluation (no 6 month diet or anything). I'm meeting my surgeon next Thursday, May 26th and hopefully I will schedule my evaluation at that time too. I'm starting a new job July 1 and was hoping to have the surgery done before I start so I don't have to take time off right away. I will have vacation time after 6 months (i think) but I don't want to have to use it when I'm new. I also don't want to have to tell my boss - it's a very small office. Me, boss and one other.

Have any of you has the process take two weeks or less from consultation to surgery? I have open availability so making an appointment with a psych shouldn't be too hard.

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Your insurance may require only a psych evaluation but be prepared as the surgeon may and often does require more. I don't have your insurance so my case was different. I first saw my surgeon on June 16 2015. I had to have by his request a MRI as he suspected I had a hernia when he touched around my tummy. Turns out I also had gallbladder issues. He wanted a cardiac and pulmonary evaluation. Your surgeon will want to make sure you are in good enough health to get through the surgery. My insurance did require me to see my surgeon for 5 more monthly visits with weigh ins but didn't say I needed to lose a certain amount. They also wanted me to have a few psych visits not just an evaluation. I feel some of these things were due to my age and disability.

Please be prepared that you may not have surgery before you start the new job. Sometimes it takes longer than we expect or want provided the surgeon and the PCP get all the paperwork in. My last visit to the surgeon was 2 days before Thanksgiving in 2015. The PCP held up my insurance approval as he wanted a surgery date from the surgeon. The surgeon didn't want to give a surgery date until the PCP wrote his letter of medically necessary. The surgeon finally gave the PCP a dummy date and it took over a month for insurance to approve my surgeries. On Jan 26th 2016, I had my WLS, hernia and gallbladder.

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I have BCBS VA. I talked to 4 reps on the phone who told me in the beginning they didn't require 6 months but then I found out through a liaison with BCBS that my plan requires 6 months. I'll attach a picture of the policy. Just be careful of that part. They required 6 months and a psych eval but my surgeon required 3 months, records from my most recent physical (had to be within the last year), 3 classes, attendance to Bariatric surgery support group, a class with a nutritionist then I had to pass a test from the nutrition class. My surgery is in less than 3 weeks. It was all worth it. I feel so prepared and confident that I'm going to be successful. post-269560-1463832815165_thumb.jpg

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My surgeon required the following which insurance did not require:

  • Swallow test
  • Pulmonologist including sleep study
  • Cardiologist

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My insurance is BCBS in NY, says same thing as yours regarding the 6th months... I have some documentation I think meets that requirement but I'll know more after may 25th...

I agree about the surgeon having their own requirement, if you went to a seminar the literature they provide has detailed information about the surgeon's requirements.

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Edited by nyteacher125

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My surgeon required the following which insurance did not require:

  • Swallow test
  • Pulmonologist including sleep study
  • Cardiologist
Isn't a swallow test after surgery in the hospital?

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Isn't a swallow test after surgery in the hospital?

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Mine required before as well. I guess to make sure all the plumbing worked as expected?

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No the test after surgery is to check for leaks... I think the pre surgery swallow test is an endoscopy to check if you have reflux and maybe other things.

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My insurance required 6 month medical weightloss and 3 years of documented weight.

My surgeon required

Endoscopy

Cardiac clearance ekg

sleep study

Meeting at a support group 1x

Social worker and nutritionist appointments

Class before surgery about the way of life afterwards

Definitely couldnt get everything done in a month.

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I was self pay. Thought about it for years. Really researched for a month, picked a Dr and booked it. From the time I decided to do it until it was over was 6 weeks!

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