ANYONE HAVE BLUE CARE NETWORK AND BEEN APPROVED?

I have Blue Care Network and I need some guidance....
PLEASE PLEASE
Katrina

Hi-
I have BCN - through Univ of MI (Premier Care).  All BCN plans are different, but I'm happy to help if I can.  What's up?



lara

What did BCN have you submit to them with your request for surgery and did you submit the request or does your primary submit the request?

Thank you
Katrina B

Hi-
My surgeon's group coordinated the submission.  They needed a letter from my PCP saying that it was necessary and that he and I understood the risks, followup care, etc.; monthly documentation from my PCP (using Premier Care's form) indicating all the steps we tried and that I adhered to related to exercise, eating, weightloss, etc.; info from my psych exam; and I think that's about it!   Is your surgeon's group telling you what you need?

Hello,
Thank you!
I have not taken any steps to start the process and that is why Im asking so many crazy questions. I have abo****ley no idea where to begin and I have a Dr. but have never gone to regular visits and I need another primary care dr right now because my other dr. is not convienant location for me soooo.. I just need all the help and advise I can get because I know I will have to see a Dr for a year before I can even try to get approval!....Daunting!!!! Im at a loss...Thank you for your help

Katrina

well, I'd start with making an appt with a primary care physican.  During the first appointment, be clear that you want to start to schedule monthly visits with him/her to document your weight, blood pressure/pulse, review your diet (complete with total number of calories they recommend you take in per week, types of food (low fat, low carb, whatever), exercise, and any medications or co-morbidities you may have.  Tell them too that you also want a referral to a weight loss surgery program (do you know if you want RNY, DS, lapband, other?? - if not, get their advice).  Be very direct and business-like with them - you'll likely need to direct these ongoing conversations to be sure you get out of the visits what you need (basically, documentation for your insurance company).

Then, once you have the referral and your PCP's agreement to help you, start to work with your bariatric group.  In the meantime, start attending the free information sessions offered by the bariatric surgeons in your area that your insurance covers.

hope this helps~

good luck!!    lara

I have bcn and was approved the first time. The first thing I had to do was see my primary care once a month for a year and have her fill out a paper of my weight loss/gain. Any other questions just email me.

I BCN was approved the first time, no problems at all
I document all the diet I had been on and the weight I had lost and all the pain I ever had in my life.

Good luck!
Denise

Thanks for resonding!
How do I get started? Do you live in close proximity of Detroit? Did you just document in your own writting and submit to insurance? If you went through your Dr for assistance and if you live in the area could you recommend your primary Dr. ? I am worried because I cannot officially document the weight history I can prove that I have consistantly gain weight and my other complaints...I just dont know how to begin?
Thank you again..this is overwhelming and I need to get this weight off of me soon....
 

I have the State BCN plan, but am still in the approval process. 

One thing you should be aware of if your BMI is high enough (e.g., over 60), you may not need to document your pre-surgery weight loss history.