Starting my journey with SOME GOOD NEWS!!!

[MaryfromMI 5]

Hello everyone!!! I have been looking around this website for close to a month now, but wasn't planning on posting for a while because I was doing a 6 month supervised diet for my insurance and figured I had PLENTY of time to post. (lol) After talking to my insurance twice (BCBS of MI) and double-checking with them what the requirements were for lap-band surgery, (because I read on one of the posts here about BC of MI changing their requirements for BMI's over 40 and mine is 40.1), I went to my PCP and got put on a 6-month diet, which began last month. Tonight I went to a seminar put on by my potential surgeon and in his presentation he informed us that as of April 1, 2008, BCBS of MI changed their requirements so that if your BMI is over 40, you don't have to do the diet!!!! So being the natural triple-checker that I am, I asked the nurse who handles the insurance for my surgeon again about Blue Cross and she said that she was 100% sure about the change and that BC never has their own information up to date when you call them. I was so thrilled!!! I am hoping to start nursing school in January and was thinking the only time I would be able to get the surgery would be over spring break in March, but now if everything goes according to plan, I can hopefully have the surgery over my Christmas break from school and have almost a month to recover instead of one week.

I am trying not to get my hopes up too much, because things have a tendancy to never go the way I want them, but I have started filling out the pages and pages of medical info for the surgeon and hope to get this ball rolling soon!!

And another thing...I found it pretty funny that at the seminar tonight I actually didn't learn much because I already knew everything the doctor said FROM THIS WEB SITE BC IT IS SO AWESOME!!! I was glad I went though to get a "feel" of the surgeon, but was secretly giggling to myself through the whole thing. :thumbup:

[stacielynntate 88]

I hope things go right for you, nice to know they changed the requirements and hopefully you will have surgery by the end of the year.

[thebandedgirl 0]

That's awesome!

I didn't learn much at the seminars I attended, either. I really did my research before I even decided to walk through the door of a surgeon's office! Good for you for putting all of the time and work into educating yourself :thumbup:

[PMOSS 0]

I have BC/BS OF AL I wonder if their requirments have changed on the 6 month pre op diet. I too just started my journey and am facing this obstacle. I think I will check up on this with my insurance company.

Good luck on your journey and I hope everything works out the way you want them too!!!!

[MaryfromMI 5]

Well if your insurance company is like mine, you still might not get the right answer if you call them. Have you attended a seminar yet? They most likely would have people there that work with your insurance everyday and can give you the answers you are looking for. You could also probably call a surgeon's office and talk to the nurse coordinator and he/she will help you out.

[PMOSS 0]

Yes I attened my seminar yesterday and had my consultation visit. That is where I found out that I have to do the 6 month pre op diet with weigh ins every 31 to 35 days so my tenative date for surgery is May 12, 2010. Boy that is a long way off.

[MaryfromMI 5]

May does seem like a long ways away, but hopefully the time will go fast. Just try to stay busy and focus on the positive and the time will fly!!!

Just wanted to add that I just got done calling my insurance AGAIN...I got a packet of papers to fill out from my surgeon and included in it was a insurance worksheet. I had to call them to ask if they covered all the potential tests, what is needed to send to insurance, etc. Once again, they told me I had to go on a 6-month diet, but I didn't argue with them, I just let the lady talk. But then she started getting mean with me and saying that all the questions I was asking should be answered by my surgeon because of an inquiry policy and there is no way the surgeon could get away from answering my questions. I explained why he wanted me to ask these questions, but I don't think she understood that I needed to do this so my surgeon could become my surgeon and not that he already was. Based on the information I give the surgeon will help the surgeon decide on whether or not I will be his patient. I hope I never have to call them again. I am always so frustrated and agitated after talking to them!:blushing: Has anyone else had to do the insurance worksheet?