
I just had my Lap Band done by Dr. Felix as his first Patient on Valentine's Day! (No Joke!) He and his team rate an A++!!! They (and Clovis Community Hospital) took care of me the best ever!
Here are a few things to get the insurance company to approve you...
1. Have your Physican state in a letter that you need the surgery because
it is 'Life Threating'. (If you have Apnea, have him state that too.) You
can write the letter and have him sign it for submittal to your insurance.
2. IF your BMI is 'over 40' then you should be considered as 'severely obese'.
(That should go in the letter too.)
3. You will probably have to prove or go thru a Physican approved 'diet' for
3 to 6 months with daily intakes of calories, etc. (I did mine in Excel.) It
also goes into submittal.
You'll have to jump thru some hoops and spend some time buliding your case to the insurance company. When you finally have all your documentation then submit it to your insurance with a copy of your medical records for review. The review takes awhile.
My best advice is to contact your insurance provider or local rep, sit down with them to see what 'their' qualifications are for approval. I listed mine by bullet point. Once you have that, then you can attack them one at a time. Once they are all done, the insurance has to approve. It's also good to have a good general doctor that your are going to and work with him. The winning edge is to be 'Proactive'!!! Take control and go thru the requirements. You can ask about their BMI qualifications too.
I'm still bruised and shaved, but I feel great!!! Lost weight already! Do the Vits and Pills, Protiens, etc. Let me know how you do or if you need more suggestions. Going thru the Prelim stuff w/ Dr. Felix's staff in Fresno will help. They have great materials. Good luck with everything! -Nick
You can reach me at:
nkeg@mindspring.com