BCBS IL/University of Chicago Questions

Hi, I am considering the band...no let me change that. I have made up my mind to get the band. I am scheduled to meet with the dietician, have a psych eval and meet the surgeon next Tuesday @ the University of Chicago. I have BCBC IL and know that it is covered. They require medical record documentation of active participation in a clinically-supervised, non-surgical program of weight reduction for at least 6 months, occurring within the twenty-four (24) months prior to the proposed surgery and preferably unaffiliated with the bariatric surgery program. The initial BMI at the beginning of a weight reduction program will be the “qualifying” BMI used to meet the BMI criteria for the definition of morbid obesity used in this policy.At least a five-year history of Morbid Obesity supported by medical record documentation. So, what exactly will be the documentation. I moved here from Tennessee like 4 years ago and while I was heavy then I don't think I was considered morbid. I am 5ft 3inches and at the time weighed between 212-218. Last year I got up to about 243. Will my doctor be able to supplement my records. Any advice or guidance would be greatly appreciated. I don't have the money to do this on my own and my credit quite honestly stinks. HELP!!!!!! How long does approaval take with U of C?

Hi! I'm new here too. Do a google search for a BMI calculator. Put in the weight 5 yrs ago with your height. It'll tell you. I'm 5'1 and I did mine, if I weighed 210 I was still like 40 BMI, so maybe you aren't too off.  I'd just gather all your files so you can go through them.  I also have BCBS and it does suck trying to do everything.

good morning,i too have bcbs of il. mine's a hmo.my understanding is i could NOT even receive the referral to see the surgeon till i had everything done. i've seen a dietitian for the required 12 months,w.w. for 6 months,psych eval,comorbitity=hypertension& have years of documentation of failed diets& obesity & u of c seminar .i had my 1st consultation last week.now dr office sends a letter to my pcp then they submit it to bcbs.dr. assistant melissa said it usually takes 2 weeks.fast....we'll see.so after i receive the approval i'll go in for my pre=op stuff.i'm getting the band,too.my great surgeon is dr. ayloo @u ofc.hope this info helps.you'll learn more here than anywhere.best wishes!

Yes, it's covered but they are gonna make you jump through tons of hoops! Don't give up! I got approved last month for Lap Band by BCBSIL PPO. I first sent in for approval around Thanksgiving of 2006 and was denied. After several appeals, I finally got my denial overturned and am having surgery on Thursday. While you are going through the pre-op testing, request your files from the past 5-10 years from your primary care physician. They're really looking for progress notes from your visit to the doctor. That's how I documented exercise. My doctor also signed off on my 6 months of Weigh****chers. Also, those progress notes have your weight listed which will help you build your 5 year history of morbid obesity. Only include those progress notes where your weight is considered "morbidly obese" or it'll come back to bite you. I hope this is helpful! Don't give up on the approval. I got discouraged at times but just kept reminding myself that this was all part of the game. You can do it!