in what order did you do all the pre-op requirements?

[kplant 0]

I am barely at 40%. The measurement I have at 40% is from jan 2007 and the min requirement is 24 months and so I may have to wait until jan. In the meantime, I need to see a gp to get a referral for the surgeon and eventually a psyche evaluation. I may also need to do the 6 mo nutritionist thing. How certain would the surgeon be that I will be approved? Could the surgeon submit my forms (this month) and then the ins will say what else I have to do to get approved?

[Lizalee 1]

HI KPlant:

When you say 40%, do you mean your BMI is 40? My insurance used a BMI of 40 as a cut-off. 30 - 40 BMI you needed at least 2 co-morbidities (hypertension, sleep apnea, diabetes, etc)

The order I did my pre-op was dictated by the Bariatric Center of Excellence that was in my insurance plan required. The ONLY way I could get into the program was to start by doing to a learning seminar to learn about the band, options, meet the surgeon, etc. I was a group thing, and they gave lots of statistics and information on insurances, etc.

After that, I could make an appointment with a dietitan. I then was able to make an appointment with the psychologist. My insurance required a 3-month supervised diet within the last 2 years, and since I had given up on dieting, I had to do that.

I had to provide 2 years medical records, and a letter of recommendation from my primary care physician.

Once ALL that info provided, passed the pysch visit, proved I could successfully alter my eating habits by loosing weight on the supervised diet and follow their recommendations - like trying Protein shakes, buying chewable multivits, etc, and kept all my appointments -- would they submit my case to insurance.

Those months were agonizing, since with a BMI of 54, multiple co-morbidities, and motivation to succeed, I KNEW I was going to be approved. But I had to go through the painfully slow process anyway.

Once my insurance approved, then, and only then, was I allowed to make the consult apt with the surgeon. That wait was also agonizing.

I had thought I would be banded by January - then Feb....etc.

Now that's it over, I realize that it was important to go through this process to reallly learn about the band, adjust my lifestyle, and appreciate the seriousness of what I wanted to do.

But I wouldn't have said that a couple months ago!

[kplant 0]

I am exactly at 40%. I went to the seminar but I guess I should call the surgeon to see what they think the next steps to get approval are. Thanks!

[waikiki 0]

First I went to a seminar and called my insurance to make sure my procedure was covered under my plan.. I had to follow certain criteria on their website in order for it to be covered. There really wasn't an "order" just had to have it all done.. 6 month diet, psych eval, etc.. the surgeon has an extended list he sends in along with the insurance list to make double sure all of our T's are crossed and our I's are dotted... it was covered at 100%.. It did take from August until now to get it all done and my surgery is scheduled for June 25th...

Good luck and it will take some time but it is well worth it!! Hang in there... :behindsofa: