Question for Federal employees

Hello All,

I am in the process getting approved for WLS. I tried this before back in 2006, but then I got pregnant....fast forward to now. Okay, so I called my insurance which is BCBS, and they explained that in order for appoval I all needed was information from my surgeon, and I assumed that was because I had changed to a better insurance company. Last time, I saw Dr. Paul Lin, and I was really comfortable with him, and I called this morning to see if I could get an appointment, and the intake lady told me a thousand things I needed to do, and all this other stuff that I was told I wouldn't need. She told me I needed a pych eval, and referral from my PCP, and all this other stuff,  which the actual insurance told me I didn't need. She told me I'd have to go to a class before I could see Dr. Lin, and before they could check my insurance, which I think is backwards.

I was wondering if any other Federal employees with BCBS PPO had these problems. If not, fine, I'll leave it alone and go through the motions, however I just want to make sure I'm not doing unnecessary work.

Thanks in advance!

I have federal BCBS too. Some Doctors do require that you sit through a meeting/seminar first. If your BMI is 40 or above, you shouldn't have any problem getting approved. You will need to see about 4-5 specialist; pulmologist, cardiologist, pysch, endoscopy...
If you have Fed. BCBS PPO, you shouldn't need a referral from your PCP, unless the surgeon just wants to see your medical history and to make sure your PCP agrees, but its not required.

And with Dr. Lin, I was considering using him as well for my revision. I was allowed to schedule an appt. with him, but it was after the date for the seminar.

Hi,

I am a federal employee with BSBC and although they did not require anything except that the surgery was medically necessary the program I went through at John Hopkins had lots of prerequisites.  I had to attend a seminar first (you can go in person or you can complete it on-line), then I had an appointment with the surgeon where I was able to ask all my questions and his office coordinator explained the whole process of pre-op appointments and the approval process.  After that I had a nutrition and psych eval.  I then had to see my PCP for the pre-op physical, blood work, and chest x-ray.  I also had an appointment for an anesthesia evaluation.  Your pre-op testing will depend on your current health and medical history.  I did not need a sleep study or an endoscopy and lots of other stuff I see some people need.  

I am currently a federal employee with BCBS PPO, and my approval process took less than 24 hours.  I went to see Dr. Moazzez at 4:00pm on Aug 19, 09 and I received the call at 9:00am on Aug 20, 09 from his surgery coordinator stating that I was approved and what date did I want to schedule my surgery. Yes I took the sleep study, endoscopy, gallbladder/abdominal ultrasound, Psych eval and chest x-ray and blood work, however a referral was never required from my PCP.  Best wishes on your surgery!