New To This and Frustrated

I am very new to this whole process. I have been wanting to do something about my weight for sometime now. I am 5'4 310 lbs have asthma, type 2 diabetes, bad knees (facing knee replacements) and then about 8 months ago I had a conversation with a good friend that went through WLS (the sleeve) and has had great results. I wanted to start right then and there only to find out that my work policy has an exclusion against bariatric surgery and any type of weight loss services. So in December, I decided to drop my coverage through work. I obtained an individual policy through BCBS of IA, which covers bariatric surgery. I also found a doctor and facility in Nebraska, which is a lot closer than any IA facilities and went to their seminar.

I have my first consultation with the doctor on Monday. When I gave them my insurance information so they could verify benefits ahead of time, they told me they called BCBS and they said it had to be done at a Blue Distinction Center and that if I went through their facility I would not have coverage. I called BCBS and talked to a representative that put me on hold for quite awhile so she could research this and came back to tell me that I didn't have to have my surgery at a Blue Distinction Center and that this particular doctor and facility were within my PPO network so I would have coverage. Well I am one that likes to hear it from more than one person so I called the next day to reverify this with a representative and got the same answer. I relayed this information to the doctors office but they are still insisting that it does have to be at a Blue Distinction Center. They even went as far as to mail me a letter stating this which I got today in the mail. I called BCBS to speak with a rep (third one I have talked to) regarding this and again they verified that it does not need to be at a Blue Distinction Center. I asked if I could get this in writing and they said that they don't have anything to send out in writing on this but that if it had to be at that center my policy would state it and it does not. How do I get the doctors office to understand this?

I checked on the rest of the requirements and all I have to do is a psych eval, nutritional eval, 2 years of weight history and have documented weight loss attempts, so this is the biggest hurdle out of them all. Does anyone have any advice?  Sorry this is so long.

This is NOT being critical. Sometimes if you use a tablet, formatting disappears. Could you edit this and put in a few paragraphs? It really isn't easy to read! 

I actually did it on my desktop. Sorry it was not easy to read. I am completely new to this site. I edited it.

Thanks   You will probably get more replies! Can't help personally as I am not in the U.S.! But good luck! 

Why not try 3 way calling, or call the ins agent on the phone, then give the phone to the people telling you have to go somewhere else., & let that rep speak to them, it might be a billing issue or sending in the proper codes so they can get paid by your insurance.

tell the provider to call for a prior authorization request for you. If they get a prior authorization then they are given an authorization number that they will submit with their claims that said it was approved. Have they even tried to call? Maybe they don't like what they don't like the contracted rates that your plan is willing to pay them to do the surgery and that is why they told you that.

they called me and said they spoke with the insurance company and was told I have to go to a Blue Distinction Center and even sent me a letter saying the same thing. So I took their word for it but I like both of these suggestions. I will call the insurance on Monday while I am there and get this straightened out.

Thanks

Maybe it is that facility that don't do the surgery. I have kaiser and they refer us out to pacific bariatric medical surgical group. We just pay a copay to them. That could be the case. But 3 way calling sounded good! 

maybe the surgeon prefers the Blue Distinction facility. Is there a problem with using a Blue Distinction facility? 

If I used the Blue Distinction facility, I would have a completely different surgeon. The surgeon I am going to on Monday is in Nebraska which is 40 minutes from me. The closest Blue Distinction facility is in Iowa which is 2 hours from me and I am not familiar with them or the surgeon. The one in Nebraska I met at the seminar I attended and am familiar with his staff. That and the convenience of it being closer is why I would like to stay with him.