Exact Steps I have to take with BCBS of NJ?

[JulieG 0]

Hi, my name is Julie, and i haven't signed up for lap band surgery yet because I'm not really sure where to start. I'll be going to the seminar in a couple days.

But after that, what's next?

I've been on prior diets for 6 months - Medifast and Weight watchers. But does the weight loss have to be documented by the doctor?

Is there a special form the doctor fills out?

My PCP says he thinks lap band is a good choice for me but never really had a patient do it under his care so I'm not really sure he knows what to do, so if someone could guide me on the steps I have to take in order for me to get approved, that it would be much appreciated! I have >40 BMI.

Thank you!

[RestlessMonkey 7]

You are safest to call your insurer. An insurance company can offer many different policies/provisions within each state so your BCBS may not be your neighbor's. Call them and find out exactly what YOU need to do.

[JulieG 0]

Thanks, but the only thing is that whenever I call up HBCBS (and I call a whole lot), nobody seems to know the first thing about steps I should talk, or even the fact that I needed to do a 6-month diet etc... Everyone I spoke to seemed clueless :thumbup:

[RestlessMonkey 7]

They are the ones who will approve/pay for your surgery. Someone there has to know what that entails. Call back and get a supervisor/manager; demand someone who knows what's required and can help you.

[OnTheWay to Thin 0]

When you call them ask for their medical policy on weight loss surgery. They should have a written set of requirements if they cover the procedure. If they still cant get that together, then once you go to your seminar you will be in touch with a doctor who specializes in this program. Their insurance people should be able to cut through all the red tape for you. Good luck.

[Riane226 0]

Thanks, but the only thing is that whenever I call up HBCBS (and I call a whole lot), nobody seems to know the first thing about steps I should talk, or even the fact that I needed to do a 6-month diet etc... Everyone I spoke to seemed clueless :thumbup:

Hi Julie! I have BCBS of NJ as well, that is my HMO. I had the same exact problem when i would call. I gave up calling. I went to my PCP who gave me a referral to the surgeon i researched (after making sure he accepted my ins.). He then told me everything that needed to be done for my ins plus all the extras he required for the surgery. I saw him in Feb 2009, and Im hoping that in July 2009 i will get my turn to be banded. Where are you located in NJ?

Just wanted to let you know that I know exactly how you feel towards the ins. company!

[JulieG 0]

It's good to know someone is going through the same with BCBS!

Right now I'm in Monmouth County but will be in Middlesex shortly.

How did you prove that you were on a 6-month diet? What kind of paperwork did you have to send in?

[Grandma26 1]

Hi Julie, I am from NJ as well. I am pretty sure that BCBS requires documented weight loss programs. WW can give you a copy of you records and you give that to your DR. They will give you all the info you need at the seminar. I am fortunate to have Oxford, they don't require any "pre-op"

weight loss documentation.

[Grandma26 1]

Hi again Julie, When I went to my seminar (in North Jersey) all I had to do was give them my insurance. They new what each insurance company requires, and what you have to do, they even made all the calls for pre-approval.

Edited May 12, 2009 by Grandma26

[JulieG 0]

Hi again Julie, When I went to my seminar (in North Jersey) all I had to do was give them my insurance. They new what each insurance company requires, and what you have to do, they even made all the calls for pre-approval.

Wow, that's great. Where did you go?

[Grandma26 1]

Hi Julie,

I went to Advance Laparscopic Associates in Paramus, NJ

They are associated with Hackensack Hospital. Here is a link to their web site

Advanced Laparoscopic Associates :: Home

I went to a few other seminars and picked the group I felt most confortable with.