New policy for Blue Cross of Michigan

Good news for a change! 

We just learned that effective Jan 1 BCN and BCBSM will be drastically revising its procedures for pre-authorization and approval.  In a nutshell:

1.  Pre-authorization will no longer be required.  Physicians will be expected to be aware of approval requirements for bariatric surgery.

2.  For patients with BMI < 50, the documentation period for medically supervised weight loss will be reduced from 12 months to 6 months.

3.  For patients with BMI >50, documentation of medically supervised weight loss will not be required at all.

For more information contact you may contact my office at (248)334-5444

Mark Pleatman MD

www.laparoscopy.com/pleatman/index.htm

Does this include all WLS procedures including the DS??

Hi Patt, I am just lurking here as you will remember I am from Michigan? I am sorta looking to see if there is anyone I know. I will not be naming names. Is it the holidays, but not as many postings as usual especially here on the MI board?

Hi Karen,  You are correct. The postings here on the MI board are way down. Some of it may be due to the natural course of things such as when people get further & further out post-op they just move on. Then some of it has to do with drama. People's feelings get hurt, they get mad or as even were banned for awhile. The banning thing seems to have slowed down quite a bit now that OH has made some changes.   Change... Just a normal course of life I guess. As the saying goes. "You're either changing or you're dying." Karen, I hope your Christmas is wonderfu, your New Year is prosperous, happy and you are successful at whatever life goals you are trying to meet.

Hi, my name is Dorree.  I see that you are from Durand, MI.  I am from Waterford.  Near Pontiac.  I know someone who is from Durand from work.  Last name VanKuren.

Hi Dorree,  I know Waterford very well. I am involved in hot air ballooning and some of my fellow club members/pilots live in that area.. Also I grew up in Ferndale, lived in Southfield while married and then lived in Howell for nearly 20 years until I moved here to Durand about 3 yrs ago. Don't know too many people in Durand. In fact, sadly, I have found it is not a very friendly place. Or at least not so far for me.  I miss Howell terribly and when I can afford it will move back there. .

Interesting - where did you get this information?  

I heard these changes were coming down when I was at my surgeon's office in October.  If only it had happened a year ago, I'd be skinny by now.  :) I was approved for surgey in late October and didn't require my paperwork to be submitted for pre-approval --- once all my requirements were fulfilled the surgeon's office scheduled my surgery.  So that change has been in effect for a while now already. Pam

I called Barix Clinic they have not seen this in the Blue Cross Info yet, but they also know its coming and are excited for all the patients.

When I went to see the surgeon in October I was told that BCBSM was changing at the beginning of the year, but I was still doing my monthly supervised doctor visits just in case it didn't get changed. I am excited that it is going to change.