BCBS GA HMO APPROVAL!
I just wanted to share that I have BCBS of Georgia HMO, hubby is a state employee. I got my approval today! They didn't have all the paperwork in the beginning because of a fax misunderstanding. It took from the time they refaxed which was showing in the system 4/16 to 4/21. They are closed on the weekend so basically 3 days total. Make sure to get all copies to EVERYTHING. That way if you call BCBS and they say they are missing something you can fax it your self. They will provide the fax number. Also I would HIGHLY recommend calling them every two days. That way you know if there are any problems. It takes nearly two weeks for anything to get to your surgeon's office if there's something missing. I knew way before they got the letter what was missing. MAKE SURE YOU HAVE A DIETICIAN EVALUATION TOO!
1. PCP Letter Letter should include you need surgery and that you are medically cleared
2. Surgeon's Letter (usually this is something they know that to write)
3. Thyroid Panel (Bloodwork)
4. Phsy Evaluation (There are ways to get BCBS to pay for this email me if you need some help on this)
5. A letter from YOU, talking about how life is hard being your size, health wise and living wise. Make sure to include any diets that you have attempted and estimate how much you've lost and gained. You can Approximate.
6. Dietician Evaluation This includes seeing a nutritionist or dietician and understanding what the surgery will Intel and what you will be allowed to eat after surgery.
MAKE SURE TO KEEP A COPY OF EVERYTHING!
Amy
Amy, congratulations!!!!!!!!!!! i have bcbs hmo too, if you have any ideas on how to get them to pay for 2nd phych eval, let me know please.. the first one wouldnt clear me ( long story) and he wouldnt see me again because he said it was a conflict of interest since i am not useing the sugeon that sent me to him... I self payed for a second one and said he thinks i would be good canidate and will give me clearance.. i pd 500 and if i have to loose it , it will be well worth it but i would love for bcbs to pay it... but they have denied so far because they paid for one already ,,, thanks kiwani my email is [email protected]
Well being you've already seen the 2nd one that will be hard to get them to cover it. Anyone that hasn't seen one and is in the Atlanta area, I would recommend Dr. Walfish. I haven't been to him myself, but he has a lot of experience and if I lived in that area I would have gone to him my self. All you have to do is call his office for an appointment and they do all the rest even with the HMO's. I'm not sure of his phone number right off hand.
Amy
HI so happy for you 
let me know and l will come and see you will talk soon.
Amy,
Could you please share your experience with me about BCBS covering psych eval. My pcp referred me to one that they use as well as the surgeon. I have the psych eval scheduled and then I have to pay $100 for a nutrition consult and I will submit that to the insurance. I am soooo excited and I am hoping that I will have my surgery around the first part of June. Anyway, I hope that this all works out for the best. Any information would be greatly appreciated.
thx
holly
Hi Holly,
Sorry for not getting back with you sooner. I will say this that some surgeon's require that you only see certain doctors in there group for the psych eval. How I got around that was I found out who a refering therapist was that was covered under Megellions plan and called for a refer as a simple therapist session. I then told the therapist that I was in need for an evaluation. I never had to answer all these questionaires. What the insurance is looking for is stability. The tests are basically disigned for the program in which your surgeon's criteria is. I was lucky that my surgeon's dietician/nutrionist didn't charge me anything for the consult. She did everything over the phone and explained about the surgery. That's basically all that consist of.
Amy
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