Surgery date with no approval??

[BandedInNY 1]

I have my surgery date, most of the tests done, and I started the liquid diet today. The doctors office told me it was too early to send the information in and get approval. My surgery date is 4-28-08. I have BCBS of NY.

Really????? What happens if they deny me? Do I have to stay on the liquid diet for longer than the 4 weeks I am on it? I am so confused?

[Brandy~ 2]

I have my surgery date, most of the tests done, and I started the liquid diet today. The doctors office told me it was too early to send the information in and get approval. My surgery date is 4-28-08. I have BCBS of NY.

Really????? What happens if they deny me? Do I have to stay on the liquid diet for longer than the 4 weeks I am on it? I am so confused?

Oh that's odd. I have BCBS of Minnesota and my doctor said he is sending it in by 4/2 and I am not getting banded till end of april or may.

[Susanbee 0]

if i could stay on a liquid diet for four weeks i wouldn't need the lapband.....

[michelle88 0]

Alesha- my dr. gave me a surgery date two weeks before the surgery was acutually approved by Healthnet. I just got my approval on Friday and my surgery is tommorrow! I think the process varies by surgeon and insurance company.

[Brandy~ 2]

if i could stay on a liquid diet for four weeks i wouldn't need the lapband.....

haha thats funny and true!

[JerseyGirl2u 0]

BandedinNY, check w/ your insurance honey.... I have BCBS also, and I'm in NJ. BCBS requires certain things, and you wont know what exactly they want until the paper work is sent in. My Dr. thought he had all the testing and reports he needed.. and when he sent it in, BCBS came back and told him I needed 3 mo. of Nutritional sessions... which brought me to 4/2. I have my last session on 4/2 and from there I'm told that BCBS will give the Dr. the authorization.... I also have a scheduled date w/ out an approval!!!!!

[Brandy~ 2]

BandedinNY, check w/ your insurance honey.... I have BCBS also, and I'm in NJ. BCBS requires certain things, and you wont know what exactly they want until the paper work is sent in. My Dr. thought he had all the testing and reports he needed.. and when he sent it in, BCBS came back and told him I needed 3 mo. of Nutritional sessions... which brought me to 4/2. I have my last session on 4/2 and from there I'm told that BCBS will give the Dr. the authorization.... I also have a scheduled date w/ out an approval!!!!!

You're very lucky... my doctor wont schedule or send the papers in until the 6th appt

[JerseyGirl2u 0]

Lucky is when you have an approval w/ a surgery date in hand!!! Not just a surgery date... LOL Hopefully by 4/2, i'll have my approval from the insurance company, and they wont want anything else. Time truly does fly... My original surgery date was 2/6... thats when I found out I need more visits w/ the nutritionist.... I will keep everyone posted! Hang in there Brandy... time flys!! You'll be banded before u know it! =)

[hnladue 7]

I have BCBS of NY.... Dr would NOT schedule my date until we had approval..... I would call them on that.... both the DR and BSBC. At first they denied me then it took another 3+ weeks to appeal and get approval..... I wouldn't want to see you on a liquid diet for 7 weeks..... I would end up killing someone if I had to do that!

[suzle 0]

I think bcbs is being really nice about the lap band...Mine came in 3 days!

[Jersey Boy 0]

Jersey Girl, I too have BCBS (Horizon) of NJ and they made me do 6 month supervised diet. They didn't require that when my papers went in but they changed the requirements 6 days before my svheduled surgey date and said no exception. I have 2 more months to qualify, then resubmit. Does anyone know for sure if they use your starting weight or your weight after the six month supervised diet???

I too had a date before approval.

Edited April 2, 2008 by Jersey Boy
additional info

[Brandy~ 2]

Jersey Girl, I too have BCBS (Horizon) of NJ and they made me do 6 month supervised diet. They didn't require that when my papers went in but they changed the requirements 6 days before my svheduled surgey date and said no exception. I have 2 more months to qualify, then resubmit. Does anyone know for sure if they use your starting weight or your weight after the six month supervised diet???

I too had a date before approval.

They use the weight that your doctor took during your initial consultation.

[Jersey Boy 0]

Thanks Brandy~ I really need some encouragement

[Brandy~ 2]

Thanks Brandy~ I really need some encouragement

I have my last of the 6 appts today! Hooray! I have been told at each appt they use the weight from the intial consultation.

I am sure they would open themselves up to some type of lawsuit if they told you to lose weight then denied you for losing it :thumbup:

[JerseyGirl2u 0]

Hey Jersey Boy... I didn't have to do 6 mo. of supervised Diets.... The only thing they requested in addition to the norm, is 4 mo. of dietitian vistis... and thats it!! Got my approval on the 28th!!! Scheduled for April 16th. Maybe it all depends on what mood the person is that is processing your paper work!!!! LoL Lots of luck.. and keep positive!!!=)