CareFirst / BlueChoice Open Access

Background: 1. I live in MD 2. I have a BMI over 40 3. I have the Open Access plan so I do not need a letter from my primary care physician for surgery 4. I have been going to My Weight Dr. here in MD for four months and can get those records   Questions: 1.  Has anyone dealt with CF/BC? What was your experience? 2. If I can, in fact, use the My Weight Doctor treatments to document the nutritional piece and I hit six months in July, is it feasible that I can get medical clearance for surgery in July? 3. Should I do the psych testing now so that I can get that out of the way? 4. How soon does it typically take to get scheduled for surgery?   Thanks,   CidGrad CareFirst / BlueChoice Open Access

do you have a surgeon yet for your wls? that would be the first step. then they can tell you what else you have to do. i had similar insurance and it was easy to get approved but you should do everything through your surgeons office. easier that way.

Hi Kim ... I do have a surgeon and his staff is great. I'm just anxious to get slotted for surgery and a I want to have it before the end of the year so I can move into 2011 with solid goals.

Every surgeon's office seems to be different.  Some require more than others.  Some require program fees.  Depending upon the surgeon's schedule and how many others are in front of you will depend upon your scheduled surgery date.  Most importantly, depending upon how long it takes your insurance comany to say "yes" will determine the time it takes you to get on the surgery schedule.  Again, all insurance companies are different as well.  I have United Health Care.  My approval took 2 days, and I was scheduled for surgery within 3 weeks of my approval date.  I did not have to complete a 6 month diet. 

I have CareFirst/BlueChoice Open Access and had no trouble getting approved.  I did have to have 2 letters from my docs stating why the surgery was necessary, I did have to complete the 6 month diet/nutrition course at Hopkins (but since you have been working with your doctor for that amount of time, you probably won't have to go through that) and I did have to have a psych eval.  I would go ahead and take care of that and get it over with. You should contact your insurance co. just to be sure of what your pre-surgical requirements are.

Omg Susan - you look amazing! Your progress is fabulous! Love the new avatar. Sorry to interupt this thread but I just had to say it. You go girl!

Thank you so much Laura!  I appreciate that. I am hoping to reach the big 100 by July!

Thanks Susan ... quick question: the two letters were from which two docs? Your PCP and your surgeon?

I am sorry it took so long to get back to you; I had my endocrinologist and my gyn write letters because both of them had recommended the surgery.  I also had my PCP write one as well just for extra emphasis . I hope everything goes well for you! 

I have the same insurance.  You still need a letter from your primary care doctor.  I was able to have my previous weightloss nutritionist fill out the required paperwork to make my six month requirement .  However, it still took me two months to get through all the testing and see all the doctors that are required.  The first doctor I saw was the end of January.  My next apt with the surgeon is on Monday to set up a surgery date.  Don't rush the process, its a process for a reason.