BCBS of Arkansas approval process questions

RileyBear
on 12/20/15 5:56 pm, edited 12/21/15 6:07 pm

I am in the process of approval to undergo a sleeve gastrectomy. Is there anybody who had/has BCBS of Arkansas that can give me an idea of what to expect? I am 49, female with a 37% BMI and have hypertension which is controlled by medication (HCTZ). Any input or advice would be greatly appreciated.

Tiki3211
on 12/28/15 4:15 pm

I have BCBS of Illinois....I'm not sure if they are different.  Mine is a PPO.  This was a easy process.  Went to my first visit with the on July 6 and was scheduled for surgery on September 29th.  I was on blood pressure meds also but had a BMW of 42.  I bet it will be a pretty smooth process.  Good Luck.

RileyBear
on 1/8/16 7:05 pm

I was approved!!!!! Note to others: Do your due diligence. Read the coverage policy for your insurance. Make sure you meet requirements. I have BCBS of Arkansas. I wrote a 4 page letter outlining the reasons why and faxed to the preauthorization team. I also had my primary care physician fax a letter of medical necessity along with the last 5 years of medical records. Everything was faxed and received by Tuesday and I had the approval by Thursday. I called every day. If anybody needs help feel free to reach out to me. Also I am a medical review nurse for insurance companies so kinda know what needs to be done. I am so excited to begin my journey!!!

 

TiredOfBeingFat82
on 10/31/16 9:30 am
VSG on 03/30/17

I also have BC/BS of Arkansas True Blue PPO.  Who did you get to do your surgery?  How has your success been thus far?  I also have high bp that is controlled with meds and my BMI is 43.6.  I know that my insurance policy says that it will cover at 60 bmi with no other underlying medical issues.  I'm just wondering if high bp is enough of an underlying issue for them to approve.  I'd love to be able to let insurance cover some of the surgery b/c my out of pocket cost would be less than going to Mexico.

The biggest issue for me on doing it here is that I don't know who to trust or use.  Everyone I know has gone to Mexico and had phenomenal results...so I'm nervous to make the wrong choice in doctors.

HW: 246 GW: Healthy & Happy

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