Not sure what BCBS of Illinois is saying......

My surgical facilitator submitted to my insurance an approval to get the lap band removed.  This letter from BCBS came in the mail and said the following:

"Based on the documentation submitted, 87656 for laparoscopic removal gastric adjustable, all parts are covered under the member's plan. However, predetermination of benefits does not guarantee payment.'

What exactly does this mean regarding my chances of getting the revision?

Congratulations it was approved it means the doctors office will get what they give under the all parts are covered for the removal.  

Why didnt he do both at the same time most doctors do even if they are not doing it at the same time..

Yeahhhhhhh You are approved

I think it was more of she didn't want it to come across as a revision even thought it's gonna be a revision. So she submitted the removal first then will submit the actually gastric later. 

Ok Every Doctor does what they want and if that works in her office than that is it.  Did the docs office call you and tell you that you were approved or did you get the letter in the mail.  ??

I would still call my insurance after you ask doctors office what that letter means.

Good Luck

TDSLF1,

I forgot to tell you,  Did you know that you can call your insurance anytime you want.  I call mine all the time to see if they received the predetermination letter and for any questions i have regarding insurance coverages.  YOU ARE ALLOWED  and the reps are usually very very nice..  I had called them before my docs office sent out predetermination letter because i was anxious and because this new COORDINATOR in his office kept telling me she THINKS things have changed for most insurances and i was pissed i have PPO and 10 years ago i did not have to go through any hoops to get approved (example the 6 month nutrition visit or losing some weight before being qualified) So i just called myself when i got off the phone with her and found out that MY insurance coverage does not require any of those things .  Please turn that card around and call that number on the back Insurance Coverage is what package YOUR JOB picked.  That is why if i am covered under BCBS you or someone else may have differnt coverage than I and vice-versa.  CALL the number  ITS YOUR INSURANCE ITS WHAT YOU ARE PAYING FOR. 

Good Luck keep us posted.

I got the letter in the mail. I have the sleep study to do and some nutritional visits according to the facilitator. These are not required by my insurance. The nutritional visits are spaced every two weeks starting in February. Kinda annoyed with having to do 6 nutrition classes after I have everything already done. Looking to shorten that process. 

Will keep in touch.

It's insurance company double talk let your Dr. Office Hande it.  If your Dr isn't sure they are going to get paid they wouldn't do surgery