Questions, Questions

Hello everyone, I am new to the boards although I read them all the time. Well I had my consultation with Dr. Duncan today and I have to get my psych evaluation and nutritional evaluation, both are scheduled the 8th and the 15th of Decemeber. What worries me is this, I have BCBS and I am hearing they are changing things. Does anyone know about this. At the office today they said get your things in ASAP if you are BCBS so they can get your paperwork in and submitted and schedule surgery. Please pray my information gets in time. Thanks Michelle

your in my thoughts and prayers ...I know you can get it all to them in time .......Just stay on top of everyone to fax there evels over to Duncans and stay on tip of Duncas office to see if they got them ...it is up to you..trust me i have been there done that LOL LOL Laura

Thanks Laura, I will, you look wonderful by the way!!

Yes, BCBS is changing their policy. Your company has to have specifically purchased the rider for bariatric surgery before BCBS will consider paying for the surgery. It all depends on when your plan year starts at work. For example, my plan year starts in Oct. Good luck!

Hi Michelle, I can relate my own experience in dealing with BCBS. I have BCBS of GA, Federal plan, and I went thru the approval period in October. The paperwork was submitted October 1st, and by October 18th, I learned I had been approved. However, I was really sweating it as I kept reading of people being denied. Prior to that, I had heard rumors about how BCBS was no longer going to be covering WLS after the first of January, 2005. I was afraid that if I was denied, it would be a panic to get the appeal process going, completed, and finally get an approval just under the wire. Upon calling BCBS a few times to see if I had been approved as yet, I asked them point blank about the rumors. They told me that the rumors were in fact true...but that if there was an approval BEFORE the end of December this year, the surgery could still be performed AFTER the first of 2005. I am not sure about the "rider" clause that someone else has spoken about here..I am sure it is something to check out. But, I would suggest that you call BCBS (usually a toll free number) and talk to a rep there and learn just what you need to do to hurry this process through for yourself. I would also try to see if I could get earlier psych eval and nutritional eval appointments scheduled...making them as soon as earthly possible, in case there is a deadline of December 31st. The appointment you have on the 15th is too close to the wire, and with the Christmas holidays approaching after that, things may slow down, you know? I wish you the very best, and I will be keeping you in my prayers to have things speeded along for you. God bless you! Pat

I wish you all the luck in the world. There is a good chance you will have everything done before the deadlines! Just really stay on top of things and dont let time get away from you. Good luck in your venture and again wishing you the very best!! Ginger

Hi Michelle, welcome to the board. It seems that we are both in the same situation, working against time to get approval before 2005. I have Aetna. I will be praying for you, GOOD LUCK. Shon

Hi Michelle! Welcome to the group, you know you are in the righ place! I will keep you in my prayers. I agree with the other replies, just stay ontop of everyone, be persistant! Good Luck, and keep us posted, Tiffany

Everyone, Thanks so much for your encouragement and assistance. I spoke with one of my fellow bookkeepers here at work and she suggested that I just call BCBS and find out the policy for us. Well great news for me!! The rep said as long as the plan was an HMO that I did not have anything to worry about and my plan will be in effect through FCBOE until July 2005 before any changes. I am so relieved!! You ladies are a blessing. I am well on my way. I am so thrilled to know. I am going to stay on top of everything because although I don't have to worry about the Jan. deadline, I do not want anything to slip through the cracks. Thanks again Michelle