BCBS POS ins question & herniated disc?

(deactivated member)
on 8/31/06 11:39 am - Paw Paw, MI
Does any know is having the herniated disc can help cut out time on requirements? I have turned in most of my paper work to my surgeon @ Borgess Hospital. The are saying I have to have 12 months of supervised documented paperwork and that it has to be every month during that 12 month period. When I call BCBS they tell me it does not have to be every month as long as there is proof over a 12 month period or longer. It is frustrating because by the surgeons office they say I have to go from 4/06 forward, but if I go by what the ins. told me I could back to 2/06. Because I did not go in March, the surgeon says no. Sorry, got off track a little. My pcp wants me to have WLS surgery before having back surgery for the disc. He wants to make sure the Neuro surgeon feels the same was when I seem him next week. I wanted to know if anyone has or knows someone with serious back problems or a herniated disc and has or had BCBS POS that this problem help to cut time of the 12 month period? Thanks for any help! This has been the best website and I enjoy reading everyone's before and after stories. It has been very helpful in my own personal journey. Becky
Marie P.
on 8/31/06 8:29 pm - Saginaw, MI
Becky, BCBS told me 12 consecutive months. Now that I've gotten the 12 months in, my surgeon's office tells me it didn't have to be consecutive. I wish that BCBS did preapprovals so I was positive everything was covered, but they don't, because I probably would have been eligible six months earlier. They told me they do random audits after the fact to make sure everything was complied with. I suspect your surgeon's office is going to do just like mine did. They're going to do their own audit of your records, make their own decision, because they don't want a problem after the fact with BCBS, either. I wouldn't think they're going to change the 12 months because of the disc problem. Marie
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