Question about Insurance Approval

Help! I am really nervous and I am driving myself a little crazy, I was wondering if anyone knew the percentage of people who actually get approved by their insurance carriers for bariatric surgery. My surgeon's office just submitted for approval last Friday (4-24-2015) and I am waiting to hear back from them. How long does it normally take? I am thinking about it non-stop, I really want this!!! Anyway, I have state insurance (Connecticut), and I have done everything requested and I have been cleared by all the specialists. Do you guys think I have a good shot? I am sure I am worrying too much, but it is really important to me. Also, I would love to hear from some people in the community about their experiences with VSG, I think it would help me to not worry as much. Thank you guys and I hope you all have a happy and healthy night!

If you've confirmed that you have coverage, and you've met all of the insurer's requirements, there should be no issue. Denials are issued when WLS is not a covered benefit, or you haven't met insurer's requirements (these are generally: BMI of 35 with comorbidities or BMI of 40; medically supervised diet; doctor in-network....).  Approval can be within 48 hours, or two weeks....there are time deadlines that insurer must follow (my insurer had 14 business days to either approve or deny, and they approved it on day 14, I'd say most people hear within a week.  Everyone drives themselves crazy waiting for their approval!

In regard to VSG, check out the VSG board.  One comment you'll see over and over again is "I wish I did it sooner!" As long as you follow your surgeon's guidelines, you should be very happy.  You have to be committed to the program. Some people don't comply 100%, and then become dissatisfied because they have not lost all their weight within two weeks.  Surgery is not the magic bullet -- it's a tool to help you.

Don't go crazy, and don't worry.  Plan on approval within a week.  Expect to go nuts on the pre-op liquid diet, and the post-op liquid diet -- you will crave "something crunchy" or "real food" -- it's normal.  You may have issues getting your fluids in -- it's normal.  You'll "get sick of sweet shakes" -- it's normal.  You'll be sore -- it's normal.  You'll have gas or have constipation -- it's normal.  You'll worry about getting all your protein in -- it's normal.  You'll have loads of questions -- it's normal.  We're all different, and we're all the same.  

WLS is major surgery, and it will change your life. Your surgeon and his/her team do everything to be sure the surgery is safe and successful.  You have to do your part too.

I am thrilled I had the surgery.  Right now I'm going through some issues because I made the mistake of getting overconfident and let carbs back in my diet - now I'm having trouble getting back on track.  Guess what -- it's normal. I know I'm struggling, but I will get back into my routine.  

Good luck to you.  Keep reading the boards.  Within a month to six weeks, I bet you'll be on the Losers' Bench, loving your new life!

Mary

Thank you so much for taking the time to respond to my post, it really means a lot to me. I hope you are right about the insurance companies. 1know for a fact that they  cover bariatric surgery and have followed through on everything my doctor asked  me to do; so I think Ian in the best position can be for now. When did you have your surgery, Mary?

If you are interested in people's experiences with VSG, be sure to post in the actual VSG forum, because some people only go to the forum for their particular surgery and done read posts on the Main board.

Lora

I know how you feel I had my consultation with the surgen last week and on friday I had the phychosocial eval. Everyone said I should have no problem, and things will go real quick from here out. Waiting for insurance approval too. Hoping to hear by next week. I find my heart racing with anticipation. Do you feel the same way??? Crossing my fingers for you!

YES!  I am thinking about it all the time! Please let me know if you get  approved. Maybe, we will behaving surgery around the same time and  we can fill each in on what to expect, or how we are feeling ect...  I just hope I get approved, until then I will be waiting anxiously!  Keep me in the loop!

I totally get what you are going through. I just found out today that i was approved for surgery and i got my surgery date, finally. It was a two week wait and it was filled with anxiety on my part. But it was all worth it! You will find out soon and you will feel relief. Keep us up to date on your progress and hang in there!

I actually got my date too!!! June first. What about you?