Did not get a good vibe from the surgeon's office today

the bariatric nurse called today because on the psych eval, the dr put by-pass instead of sleeve.  She asked me for sure which surgery I was trying to get approved.  When I told her the sleeve, she said she has had problems getting FED BCBS to cover sleeve procedures, they approve sleeves for only very specific reasons.  I asked her if I should do a pre-emptive letter to the insurance company but she said no.

I'm such a wreck now.  First it was worry over gaining during the 3 months supervised diet now this.  My daughter is getting married in September and I desperately wanted to be a normal size by then. 

I know worrying won't help anything and there really is no sense getting upset before the insurance co makes its decision, but this is damn frustrating!

Thanks for letting my whine/vent.

Think I'll call the ins co now just to see what they say.

Crystal

Let us know what they say!! I too have fep blue and there is no way in hell that i want that freakin bypass! I hope they approve you super quick so u can be a bombshell at that wedding!

Hang in there!! Keep us posted!!!

Are you talking about BCBS Federal?  If so, I have that and they approved me with no problems on the first try.  It was pretty quick too.  I had a BMI of 46.5 and the only comorbidity I had was sleep apnea.  Unless they have changed somethng in the last 9 months, you shouldn't have any problems getting it approved for the sleeve.  Just make sure they submit it for the sleeve and not RNY.  Good luck!

I have the same insurance and was approved in 2 days, with a BMI of 40 and NO co-morbidities.  I'd have them put it thru again.......

BCBS-FEP approved me in under two weeks, no problem.  But I know folks in other parts of the country have had issues with them.  If they deny, appeal.  You will win.

NIH has set a new standard of 40 BMI. They disallowed me one day and approved me the next after the insurance person from the hospital and I discussed the situation throughly. When they claled back the next day with my denial # for the hospital, she was very clear with BCBS that not only did I met the NIH standard for the sleeve surgery but that we would be taking this to BCBS's Medical Director. And BCBS changed their minds in that same phone call. What a roller coaster! Hope this helps. Good Luck with it all.

I to got approve with BCBS Federal in one day.  BMI over 50.   Believe you will be ok,if not appeal.
Keep us updated.
Joyce

Thanks everyone!!  I did call BCBS and of course they said there is no way to know any percentages of sleeve denials everything is evaluated on a case by case basis and based on medical need,  so now I'm just waiting.

I made sure I stressed to the nurse that I do not want bypass surgery so hopefully everything goes through without a hitch.

Please say a little prayer for me

Crystal...a glitch on the psych paperwork no worries...BCBS FED were the FIRST ones to APPROVE VSG since back in the day...when it first became an INVESTIGATIONAL WLS.

Do not listen to anyone discouraging you from the surgery of yer choice. Bariatric NURSES, financial coordinators...KNOW NOTHING about your insurance policy. DO NOT LISTEN to em!!

KEEP ON EM...to make sure ya got everything....get the date they submit the paperwork...

after 2 days.  CONFIRM with your insurance they got  the paperwork WEIRD THINGS HAVE HAPPENED..so make sure you VERIFY with yer ins. company...very important!! ...

GET THE DATE your insurance company received it.  7 business days from that date. CALL EM and ask the status of your case.

Don't be surprised if it was denied... ITS STANDARD insurance practice!
Ya APPEAL IT...ya win on appeal! PERIOD.

But I'll be crossing my fingers legs n eyes for ya to get approval OUT THE GATE!