ins co update

HR agreed that new insurance company should follow old ins co guidelines since my union contract states I will have BCBS or equivilant ins....  soooo  WDYT?

BCBS-MI bariatric surgery guidelines says "physician supervised diet with periodic weigh ins".  That is very vague to me.  How often is periodic?

We have a program at work called "Health Steps"  In order to join, you must have your PCP approval.  PCP is given a copy of all weights, labs, excersize and must approve continued participation every 6 months.  This program is administered by a nutrionist.  

I'm hoping to use this as my documentation for the physcian supervised diet.  I've been a member of Health Steps since April 2006.  During this almost 2 year period i have also seen PCP at least 10xs

Also, BCBS no longer requires preapproval for bariatric surgery as long as the surgeon follows the approval criteria.  So how would I know if they accept this until after surgery is done, then bill is submitted.  I don't want to be stuck with the bill....KWIM?  I meet all the other req with no question.

I'm not real sure why you don't talk to Jodi at NB because when i had my WLS done there by Pilkington, I had my documentation required and written up and they did all the rest.  have you spoken to her and see what she said you need to do?

dr sabir said i had everything and after nut eval he would schedule me.

THERE YOU GO!  YOU'RE ON YOUR WAY~!!! GOOD WORK!

thank you, I guess I'm just shocked b/c I thought it would be a lot harder than that.  I was ready for a fight, but grateful that I won't have to! (unless current ins co refuses to follow BCBC guidelines as requested by my HR...then the battle will begin).

The two Jodi's at that office are amazing.  I had Pilkington so I see Jodi Campbell, but she had me approved in less than 24 hours and I had pre ops within about a month.  It was a rough ride with other personal crisis in my family but it got done. Sometimes  all you need to do is just ASK. i'm happy for you Stacey

Dr. Sabir's Jodi (Carrick) has been gone the last few weeks.  I haven't asked why (none of my business :-) but Jodi Campbell handles all the insurance stuff for both docs.  I agree she is awesome.  I was supposed to have nut eval today, 5 month old has stomach bug so I'm home "sick".  I left a voicemail at 4:30 this morning for central scheduling (they schedule dietician appts) that I was cancelling due to ill child and to please give Cheryl my message.  Jodi called at 10:30 wondering why I missed appt.  I told her what happened and then I called scheduling back.  They didn't respond when I said Cheryl never got the message, but rescheduled me for 2/11.  I'm going to call Cheryl tomorrow (I work in Same Day Surgery at CMCH) to see if she can fit me in somewhere else.  They said the appt is 75 min.  My lunch break is only 30 min, but if we have a slow day I can usually sneak out for a little longer.  I'm hoping to get it done sooner so I can get on the books!  Dr. Sabir said I don't need an EGD so this should be my last preop requirement (other than PAT and lab work). HR said they should know by Monday if ABS (new ins co) will honor their request to follow BCBS guidelines.  I only have 12 days from the day I spoke with HR to file a grievance, Monday would be day 8.  I'm a little nervous about missing my window of opportunity so if I don't hear anything by day 10, I'm filing one just to be safe.  It can always be dismissed if ABS complies. :-)