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  1. #1
    Gastric Sleeve Member
    I have not had a gastric sleeve.
    Dr Samuel Wasser
    Join Date
    Jun 2019
    Last Activity
    06-13-2019 11:29 PM
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    Default Revision approval - Independence Blue Cross (Philadelphia)

    Hi everyone. Brand new here and in the process of completing insurance requirements for a revision from band to sleeve. Does anyone have Independence Blue Cross Insurance? If so, what was your experience with the requirements and approval?

    I’m almost all the way through my required appointments and my second of three nutrition visits is on Monday. I initially went for a consult on May 9 where I was completely unfilled and now I’ve been able to eat (before that I was sliming and/or throwing up anytime I ate). At that appointment, the doctor was all gung ho about getting this done, he’d have no issue getting it approved, etc. and today as I sat down he was asking if I was still interested in revising. I was a bit taken back and shared my concerns about insurance approval since my BMI is now under 40 since I can eat (first visit it was exactly 40). He said they go by the initial weight (so BMI they are submitting will be 40) and he’d have to “get creative” with IBX because my EGD showed no slip and my band is in place.

    Can anyone please reassure me here? I’ve gone through all these appointments and copays and now feel like this may not happen.

    Thanks for taking the time to read this.

  2. Gastric Sleeve Surgery With Weight Loss Agents
  3. #2
    Gastric Sleeve Member EllisM80's Avatar
    I have had a gastric sleeve.
    Surgery date
    Dr. Clifford Black
    Join Date
    Nov 2018
    Last Activity
    12-24-2019 10:27 AM
    Valley, Alabama
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    Default Re: Revision approval - Independence Blue Cross (Philadelphia)

    I had Blue Cross and my BMI was supposed to be at least 35. I even lost some weight before my surgery. It was exactly 2 weeks after my doctor submitted for approval before they approved. Blue cross Blue Shield likes to wait til the last minute before they show any signs of approval. They like to see you sweat.

    HW: 315 lbs (2008) Maintained at 296 until 2015.
    SW: 255 lbs (10/11/18)
    1 mth post op: 229 -26lbs
    8 weeks post op 213 -42lbs
    3 months post op 197 -58lbs (at home)
    3 month post op appt 196 -59 lbs (1/28/19)
    6 months post op 171 -84 lbs (4/11/19) (at home)
    9 months post op 150 -105 lbs (7/11/19) (at home) *GOAL*
    1 year post op - maintained at 150

  4. #3
    Gastric Sleeve Member WANAGL's Avatar
    I have had a gastric sleeve.
    Surgery date
    Dr. Robert Marema
    Join Date
    Mar 2016
    Last Activity
    01-09-2020 06:15 PM
    Hampton Beach, FL
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    Was Thanked 907 Times in 688 Posts
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    Default Re: Revision approval - Independence Blue Cross (Philadelphia)

    I have no experience with this...

    I offer All Good Thoughts and Prayers ;-)

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