Yet ANOTHER Texan!

[jenniferann6 0]

pj, her name is Mary Beth George, number is 281.812.7529, she's right off Kingwood drive, you may want to call Peggy again until you actually get her on the phone, she's not real good at returning messages, or at least she hasn't in the past, usually I call to confirm our appt and she's not called back on them.....when you first meet her, you think "Eat woman"!, that's the way she was described to me and they were right, she's very nice. anyway, let me know if I can help you around.....

[cisco29 0]

I don't want to sound discouraging. I have BCBS TX also. I have sleep apnea, arthritis, high cholesterol and back problems and the insurance still insisted on a 6 month dr supervised diet. My whole process took 9 months. On the bright side I had a low BMI, if you can call it that. My BMI was 36 or 37. If I can get approved, anybody can. I guess my point is don't give up. It can take some time! When I started my process I was not aware of how long it would take. The time does truly fly by. Before you know it you will be eating liquids and mushies. I wish you the very best of luck!!!

[PJ333 0]

Thanks for the info jenn!

I have my appt with Peggy Wednesday.

My next appt with my GP is next week. I need to find out if I need to reschedule it because it will only have been 28 days between visits.

Heaven forbid I don't want BCBS to reject me because my visit was 2 days shy of 30 days.

[Ara 1]

Any info about the process with BCBS TX would be helpful if you could pass it on.

I'm in SE TX (right on the LA/TX state line on I10)and hope to use Dr. Dean in Beaumont. I more than qualify on BMI, type 2 diabetic, arthritis, high cholesterol, GERD,slleep aptnea..jeez when I write it down really sounds like I'm falling apart doesn't it? LOL

Ara

[TabathaPhillips 0]

Dr. Wilkenfeld did my surgery on 6/12/07. He's wonderful. His wife is the RN in the office and gives you her cell number for any and all questions that you have. She provides you with an email address as well. Most of his staff has had lap-band surgery as well so they are very sympathetic.

Good Luck!

[PJ333 0]

Hiya Ara - I'm in the Houston area :tt1:

First -

Call the 1-800 # on the back of your insurance card and ask them if your particular policy covers the surgery. Just because you have BCBS-TX insurance unfortunately doesn't mean that your policy covers it.

Just in case it does...

Here's some info from the BCBS-TX website:

http://medicalpolicy.hcsc.net/medicalpolicy be sure to scroll down and click "I agree" then on the next page in the search box type in "morbid obesity" - click GO. a there will be a link for "Surgery for Morbid Obesity"

click on the link.

This page gives all the parameters that must me met in order to be considered. It does require a 6 month medically (Doctor) supervised diet that includes a nutritionist and excercise program.

I'm on day 1 :tongue:

Good luck with your quest!

[PJ333 0]

Dr. Wilkenfeld did my surgery on 6/12/07. He's wonderful.....

Good Luck!

Thanks Tabatha!

[jenniferann6 0]

hey Tabatha, thanks for the encouragement re: Dr. Wilkenfeld-I'm almost thru with my 90 day program! Feb 15 to be exact-

[TabathaPhillips 0]

I would double check the 6 month diet plan because it usually has to be within either 2 or 3 years. I had my records from Weight Watcher's from 2 years prior so I didn't have to follow the 3 month preop course that the insurance company requested.

I have herniated disks in my lumbar spine so I didn't have to do the exercise program either. My Chiropractor had records and I had MRI results so the insurance waived that as well.

Peggy Rainey is a great dietitian. She's very knowledgeable but is difficult to reach sometimes.

[NoMoreYoYo 0]

It seems every BC/BS policy is different depending on how it is written for your employer.

I have BC/BS and I found out I have no requirement for a dr.-supervised diet. I was also told by our HR department that we are basically self-insured and BC/BS just handles the claims and that is why the requirements are not as strict.

I still have a lot of paperwork to gather up to submit - weight records, letters of recommendation for surgery, etc.

Good luck, everyone!

[jenniferann6 0]

DO NOT USE MARY BETH GEORGE IN KINGWOOD TEXAS, SHE WILL NOT RECOMMEND YOU FOR SURGERY UNTIL YOU'VE SOUGHT OUT MORE TREATMENT FOR PSYCHOLOGICAL ISSUES. I HAVE TO SEE ANOTHER PERSON FOR THE PSYCH EVAL, THE ORIGINAL ONE THE DR'S OFFICE RECOMENDED. I REPEAT, DO NOT USE HER, SHE IS TEENY TINY AND COULD CARE LESS IF YOU GET APPROVED:angry:-

my nutrst was not covered either-but I was able to do the exercise program with her as well. If your in Conroe are you using Peggy? She's nice; I found a person to do the the psyc eval for $100 in Kingwood, she specializes in the over eating thing or whatever they call it. The only difference is that I only have to do 90 days, not 180.

And, yes, I agree, it's alot of money, things have been tighter here too, I've heard it is so worth it though.

[jenniferann6 0]

pj, her name is Mary Beth George, number is 281.812.7529, she's right off Kingwood drive, you may want to call Peggy again until you actually get her on the phone, she's not real good at returning messages, or at least she hasn't in the past, usually I call to confirm our appt and she's not called back on them.....when you first meet her, you think "Eat woman"!, that's the way she was described to me and they were right, she's very nice. anyway, let me know if I can help you around.....

I STILL HAVE TO SEE ANOTHER PSYC, SHE DID NOT RECOMMEND ME FOR SURGERY-MARY BETH GEORGE WAS VERY RUDE AND COLD-DR'S OFFICE SAID GET ANOTHER OPINION, SAVE YOUR MONEY AND USE CAROL PAYNE IN THE WOODLANDS, SHE'S VERY SWEET, AND THE ONE RECOMMENDED BY WILKENFELDS OFFICE