Federal Blue Cross Blue Shield

I have federal BC/BS and I am seeking a revision surgery.  I know they cover weight loss surgery but here is my problem.  I do not have a previous 5 year medical record due to not having insurance in the past and not being able to pay for doctors visits.  I also have a BMI of 37.  The only other health problem I have is constant heart burn which I take prilosec otc for and I do have back pain due to being over weight.  Do you think I will have problems with approval.  I especially would like to hear from people who have federal BC/BS.

Hi! I also have Fed BCBS & was just approved.   They did not have my 5 year history.   I filled out the paperwork from the surgeons office.  They ask multiple questions.  About diet & medical history etc.  I also submitted with this a copy of an old Weigh****chers log I had found, & my prescription history showing my rx for Meridia. Had Nutritional eval, Psych Eval, & letter from my PCP, who I have only been seeing for 3 years, (and that wasn't even indicated in his ltr).   The Surgeon's office sent in pre-determination letter on 9/13 then faxed on 9/20, it was Logged into BC system 9/21, & approved yesterday. Did you go to weigh****chers or any other program that recorded your weight.  What about your Dr from 5 years ago  did you have a weight problem at that time what was you BMI?   Oh yea! You need to access BC Bariatric Blue Distinction center providers.  Here is the link. hhttp://www.bcbs.com/innovations/bluedistinction/centers If you have anymore questions I'll be happy to answer them.  Kerri

Kerrie, Thanks for answering my question.  Most of the diets I have attempted have been over the counter such as metabolife, dexatrim, calorie counting, and atkins.  I did weigh****chers maybe 5 years ago and I no longer live in that state where I started the program.  As far as doctors are concerned they only keep records 1-2 years and they are shipped off to storage somewhere.  The only times I went to the doctor was to places like urgent care for minor situations.  I appreciate your help.

Did they weigh you when you went to Urgent care?  & by law They have to keep medical records for 7 years, & they can pull them.  However, there may be a charge.  They can do that too.  Unless you have them sent to your current PCP.   As you can tell I also work in a medical setting so am familiar with the laws.   With Fed BC I found the process relatively painless.  Which plan are you on?  & Make sure you go to one of the Blue Cross Distinction centers.   Anything else you need, just ask.  Have a great weekend. Kerri

Kerri, Again thanks.  I have federal BC/BS PPO.

Hi!!  BCBS fep has been really good to me.  I haven't tried a revision...just had my surgery at the end of August.  I assume they are not any pickier about revisions, though.  I didn't have but one year of weight and a card from Weigh****chers for another year.  When I called, the rep said I need all five years.  I submitted dated photos for the missing years.  The photo's had the date stamped on the back at the processing center.  I was approved in 3 days.  Good Luck and keep us posted!!