Anthem Lumenos

[kyleegirl01 33]

Had my follow up visit with my doctor (Dr. Umbach) today to make sure I have everything in before we submit to insurance. I have Anthem Lumenos and the requirements seem to be pretty easy in comparison to others I've heard about. Now it's in god's hands and I have to wait to see if I'm approved or not.

I'm 5'4" and weigh 238 pounds. Has anyone else had experience with this plan? How fast were you approved? I've read that some are getting it back pretty quickly but the Dr's receptionist said 2-3 weeks. I'm really hoping for a surgery date in September.

BTW anyone looking for a Dr. in Vegas - I LOVE Umbach, both he and his staff have been amazing helping me start my journey.

[mmmorgan 0]

Hey, I'm also one of Umbach's patients and I've been looking all over for someone who is also a patient of his. I just went in there today and spoke to Holly. I have everything done and all I'm waiting for is for her to submit my package to my insurance. She said tomorrow... We'll see.

Have you talked to anyone else who has been banded by Umbach? I can't find hardly anyone out there.

[kyleegirl01 33]

Hey mmmorgan! Have you heard anything back on yours yet? I had a small hiccup with my PCP sending over lab work but it was addressed Friday so I'm hoping everything will be sent in today and I get a quick approval :biggrin:.

Have you been to any of Umbach's support group's yet? I need to go at least once before surgery and am excited to meet some of his other patients. :ohmy: I do know one other patient banded by Umbach, she's the one who referred me his way.

[kyleegirl01 33]

Still nothing back yet from the insurance. I realize it's only been 3 business days but I've heard that BCBS has a quick turnaround so I'm ANXIOUS to hear something.

Crossing my fingers for an answer by Friday.

Height: 5'4"

Starting Weight: 240

Highest Weight: 245

Last Weigh-In: 238

Surgery Date:.... hoping for late Sept:thumbdown:

[mmmorgan 0]

I haven't heard anything yet from my insurance either. I was told my claim was submitted by Blossom Bariatrics last Friday. Still, nothing is popping up on my insurance website about the claim. I've heard my insurance is pretty fast at authorizing this but I'm not quite sure it was really submitted last Friday. We'll see.

Any news on yours yet?

[kyleegirl01 33]

APPROVED!!!! ..... kind of :biggrin:

I heard from Blossom Bariatrics Friday that I had been APPROVED however the insurance said they weren't a COE (pretty comical considering Anthem's website lists them as having the certification AND Umbach is the director). At any rate it looks like surgery will be 9/16. I can't wait!!! I will update once I hear a FIRM approval right now I'm holding off the happy dance but have a BIG smile.

Height: 5'4"

Starting Weight: 240

Highest Weight: 245

Last Weigh-In: 238

Surgery Date:.... hoping for late Sept

[kyleegirl01 33]

APPROVED!!! I'm officially scheduled for surgery on Sept 16th. *Doing happy dance* I am so excited to get this new tool that will help me lose my weight and reduce my PCOS symptoms. *Doing happy dance... again*

YAY!!!!

Height: 5'4"

Starting Weight: 240

Highest Weight: 245

Last Weigh-In: 238

Pre-Op: Sept 8th

Surgery Date: Sept 16th

[mmmorgan 0]

Looks like we might get banded on the same day! I have not been approved yet but it's pending review with my insurance as we speak. I had an appt. today and Dr. Umbach said that if my insurance approves soon, I could schedule for the 16th since my husband is getting deployed on the 20th. I will let you know when I hear something.

Oh, and congrats!!!!

[kyleegirl01 33]

We probably crossed paths at the office, I was there today for my pre-op appt. I'll be crossing my fingers for you. It would be great to have a fellow bander who had the surgery on the same day as me from the same doctor.

Good Luck!!:thumbup:

[mmmorgan 0]

Just found out this morning that I was denied. My denial letter was faxed to BB and it said that I wasn't heavy enough. But the next line said I was 108 pounds overweight which meets my insurance criteria so I'm not sure what's going on. I'm waiting for Holly to contact them to get the ball rolling.

[kyleegirl01 33]

Hang in there mmmorgan!!! My first letter said denied because Umbach wasn't a provider (he's the FREAKING medical director of the hospital BCBS recommends... GEEZ!) Holly fought and got me approval. Holly is GREAT at this, have faith in her if it can happen Holly will make sure it does.

[mmmorgan 0]

She said the same thing. She said she'd fight for me. Man I hope so. I'm so desperate right now.

So you were denied at first? How long did it take for them to approve?

[kyleegirl01 33]

4-5 days, I can't remember exactly. What insurance do you have?

[mmmorgan 0]

That's not long at all.

I have Tricare....

[kyleegirl01 33]

You should be okay, you may not have the 16th surgery date but from what I've read on here TriCare isn't the most difficult. Hang in there:)