I need some help from anyone that has blue cross blue shield..... as well as other...

hayleyskinner1394
on 12/16/16 12:59 pm

Yes ma'am.... I'm sure... My patient advocate told me it was.

(deactivated member)
on 12/16/16 2:09 pm
Cathy H.
on 12/17/16 8:14 pm, edited 12/17/16 12:17 pm
VSG on 10/31/16

I have BC/BS.  I met the qualifications for surgery with a BMI of 56.  They did require a 3-month doctor supervised diet prior to surgery (which I think was a requirement by my employer insurance people, not BC/BS).  Once I completed that, the surgeon's office submitted the paperwork and I was approved by BC/BS within a week...they actually notified me before the surgeon's office.

I could have had the surgery less than 2 weeks after insurance approval, but my surgeon wanted me to do a 2-week pre-op clear liquid diet, so it was almost 4 weeks until the next available date.  Had surgery on Halloween!

Best of luck with your surgery, you won't be sorry!

Livin' La KETO Loca!!
134 lbs lost since surgery, 195 overall!! Initial goal reached 9/15/17, (10.5 months)!
5'3", SW*: 299 GW: 175 HW 3/2015: 360 PSW* 5/2016: 330 *PSW=Prog Start Wt; SW=Surgery Wt

M1 -31, M2 -10, M3 -15, M4 -16, M5 -8, M6 -6, M7 -11, M8 -8, M9 -8, M10 -4, M10.5 -7 GOAL

hayleyskinner1394
on 12/17/16 10:40 pm

Thank u so much for replying... When u got told ur requirements ... What exactly were they??? Mine was 

See a therapist

Get blood work

Ekg

Then send in insurance ... 

Cathy H.
on 12/18/16 7:21 pm
VSG on 10/31/16

Well, first let me say that I specifically chose a BC/BS Bariatric Center of Excellence for my surgery.  So I already know the program was approved by BC/BS. I never spoke directly with BC/BS, it was all handled by my program.  All I did was send in the paperwork the program required, then go in for my initial consultation.  I live 2 hours from the hospital so they were kind enough to schedule my consults with the surgeon, nutritionist and psychologist on the same day...all gave me the thumbs up that day.  Then had to endure the 3 month diet (lol).  Once that was completed, they sent the paperwork to my insurance. I went in Oct 11 for my pre-surgery consult and blood tests.  I did have to have another Hemoglobin A1C prior to surgery as I was a diagnosed Type 2 diabetic at the time.  Scheduled surgery for Oct 31, and started the 2 week pre-op diet on Oct 17.  

Livin' La KETO Loca!!
134 lbs lost since surgery, 195 overall!! Initial goal reached 9/15/17, (10.5 months)!
5'3", SW*: 299 GW: 175 HW 3/2015: 360 PSW* 5/2016: 330 *PSW=Prog Start Wt; SW=Surgery Wt

M1 -31, M2 -10, M3 -15, M4 -16, M5 -8, M6 -6, M7 -11, M8 -8, M9 -8, M10 -4, M10.5 -7 GOAL

hayleyskinner1394
on 12/18/16 8:32 pm

Thats great!!!!  so when did they submit your insurance.....?  the first day i went into true results... i got blood drawn... ekf.. heart and lung test.then the following week i went to psychologist... and everything was great.... my patient advocate told me that .... once i did those things...  they would submit to my insurance ... and then i would get a call from them... for an appointment at my surgeons office... so if i had to do a  3  month diet ...would they have already told me?? or would my surgeon tell me???

 Thank you!

Cathy H.
on 12/18/16 11:47 pm
VSG on 10/31/16

Let's see...I had my last checkup with my PCP for the 3-month diet on Aug 25th.  There was some confusion about faxing paperwork that took a couple of weeks to get all straightened out (oy vay).  My program received all the info they needed from my doctor (last diet checkup, new A1C, and clearance for surgery) on Sep 14th, they submitted the paperwork to BC/BS on Sep 21, and I was approved on Sep 30th.  I found out about the 3 month diet after submitting my initial application with the program.  I sent my application information on May 13th, they notified me on May 20th that BC/BS said I had to complete the 3 month diet, we determined that would end at the end of August, so at that time they schedule me for the intial consultations on August 2nd.  I scheduled an appt with my PCP on May 25th and began the diet that day.  

I was really bummed to find out I'd have to wait 3 more months after taking 8 years to decide.  I had been approved for and had Lap Band surgery scheduled in April of 2008, but changed my mind at the last minute.  No pre-surgery diet was required then, but my plan added that requirement in the interim so it was a big shock for me.

I would think by now you would have been told if you have to do the 3 month diet.  My program found out by contacting my insurance plan after I submitted my application as they were familiar with the fact that some BC/BS plans require different things than others.  Best thing I can suggest is to ask your surgeon's office or contact your BC/BS plan directly.  The sooner you know, the sooner you can start.

 

Livin' La KETO Loca!!
134 lbs lost since surgery, 195 overall!! Initial goal reached 9/15/17, (10.5 months)!
5'3", SW*: 299 GW: 175 HW 3/2015: 360 PSW* 5/2016: 330 *PSW=Prog Start Wt; SW=Surgery Wt

M1 -31, M2 -10, M3 -15, M4 -16, M5 -8, M6 -6, M7 -11, M8 -8, M9 -8, M10 -4, M10.5 -7 GOAL

hayleyskinner1394
on 12/18/16 11:52 pm

that is sooo true! i would hope they would have told me already.. but when they told me the requirements..they didnt say anything about the diet,,,accept the 2 week diet before surgery... i have been calling my insurance like eveyother day... to see where my approval..just so i no.. thank you for getting back tome

 

Cathy H.
on 12/19/16 12:05 am
VSG on 10/31/16

You are very welcome!  Good luck and hopefully you'll be joining the Loser's Bench very soon!

Livin' La KETO Loca!!
134 lbs lost since surgery, 195 overall!! Initial goal reached 9/15/17, (10.5 months)!
5'3", SW*: 299 GW: 175 HW 3/2015: 360 PSW* 5/2016: 330 *PSW=Prog Start Wt; SW=Surgery Wt

M1 -31, M2 -10, M3 -15, M4 -16, M5 -8, M6 -6, M7 -11, M8 -8, M9 -8, M10 -4, M10.5 -7 GOAL

Valerie G.
on 12/18/16 4:50 am - Northwest Mountains, GA

With my experience with UHC 11 years ago,  I had to provide evidence of morbid obesity for at least  2 years, list my weight loss attempts, and have a letter from my PCP that supports my decision for WLS.  In addition to that, I had to go through a psych evaluation to make sure I'm making a sound decision.  That was it for me, no pre-op dieting requirements or anything.

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

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