Letter to Insurance

[NDgirl 0]

Has anyone had to write a letter to their insurance informing them that you are considering LapBand and you know what it is about, why you are having it, the dedication.

If so, when did you do it?

[hpegg 0]

I found in most cases once a decision is made and the patient informs the doctor, the doctor's office submits the request. Most doctors know the process each insurance company requires from a patient. You may want to check with your physician first. If you are going to a center where they specialize in lapband surgeries, they will help you through the whole process and fill out all the paperwork for you.

[babycakes68 0]

HELP! My doctor and I have decided that i'm a perfect candidate for the Lap Band. I have gone through all the steps necessary. Surgeon Consult, Psych eval, Nutritionist Eval, I'm just wainting on BCBSIL to approve the surgery. As most of you know I;m required to submitt hystory of medical supervised, or commercial diets within the last 5 years, and 6 months of hystory on supervised diet.

My doctor PCP wrote a letter giving the last 3 years of hystory of yo-yo dieting and 6 months of medical supervised diet. However BCBS is not satisfied with that. Has any body experienced that? Please let me know what experiences that you had in regards this issue. I'm hoping to get banded before the end of the year. PLEASE!!!

[babycakes68 0]

ND-girl, in answer to your question, Yes, this letter was written by my PCP. The letter stated that:

I've been his patient since such & such date, that I'm 5'2 tall and my weight had been between 171 and 200 lbs for the last three years. I had tried and failed numerous diets which he had supervised. I've also exercises several times a week. He also attached the weight and date fluctuation for the past three years.

In addition to that he added my medical conditions, which are high cholesterol, sleep apnea, back pain and depression. He emphasied that he supports my decision and that he believes that my medical conditions will greatly improve with the surgery.

I thought that will be enough but apperantly not.

[teacherica 0]

HELP! My doctor and I have decided that i'm a perfect candidate for the Lap Band. I have gone through all the steps necessary. Surgeon Consult, Psych eval, Nutritionist Eval, I'm just wainting on BCBSIL to approve the surgery. As most of you know I;m required to submitt hystory of medical supervised, or commercial diets within the last 5 years, and 6 months of hystory on supervised diet.

My doctor PCP wrote a letter giving the last 3 years of hystory of yo-yo dieting and 6 months of medical supervised diet. However BCBS is not satisfied with that. Has any body experienced that? Please let me know what experiences that you had in regards this issue. I'm hoping to get banded before the end of the year. PLEASE!!!

Did you give BCBS a weight history from just one Dr? I had to submit my weight history from other Dr.s from the last 2 years. That REALLY helped them decide on approval after a denial and an appeal process! Don't be discouraged. Just be persistant and ask your provider to help you. My provider actually spent time talking with the nurse who was reviewing my file for approval. I must have received 10 phone calls that day about getting more info to them. My provider said later that more info was needed and she had to keep working with the nurse from my insurance company to make sure I got the approval. You can't do it alone, get the help from the provider! They should know a lot about your approval and they should be 100% involved!

Good luck. It took 1 month from start to denial, than 1 more month of waiting from appeal to approval for me. Before that, I had to do 3 months of supervised diet. I started in June and am finally being banded on Dec. 3rd. So glad it took so long because I spent 2 months on the preop diet in addition to the 3 months of supervised dietician diet. I have really changed my eating habits and proved to myself that I can do this. I needed this time. A blessing in disguise.

[TQUAD64 9]

Has anyone had to write a letter to their insurance informing them that you are considering LapBand and you know what it is about, why you are having it, the dedication.

If so, when did you do it? :grouphug:

Wow, I never heard that before. I did not have to do that. I have Blue Shield with CalPers, which is managed by Hills Physicians in California.