BCBS of MN - any issues??

Hi, I'm pretty new here. I'm just curious if anyone who has BCBS of MN and give me some insight into their journey. I've got all of my ducks in a row so far.....>40 BMI, type I diabetes, hypothyroidism (normal with meds), recommendation letter from endo, medical records, psych eval, etc. My only nervous part is the 6 month diet, which my endo swears I shouldn't need. I have two sets of documentation from WW...one for 9 months and another for 6 months. I also have documentation from my personal trainer, all the sessions I attended for 9 months straight along with strict calorie diet, etc. I have all the printouts from my gym for every time I was there (which was A LOT). My doctor has always supervised me, but I only saw him every 2 or 3 months instead of every month. I just wonder if this will be a problem. My endo keeps telling me I don't need the 6 consecutive months, but I don't want to get too far down the road just to find out I have to start all over because of that one thing. Any advice would be great!!!

Thanks,

Amy 

Hi Amy. I am not really sure if the documentation you have will be sufficient or not. Maybe your Endo knows something and has experience with this type of situation before. I would suggest calling the surgeons office or the insurance company directly and find out what kind of input you get from them. I always kept records of who I spoke with and when in a notebook so that I could go back to it if needed. In the meantime, you could start with a visit to your gen. doc just to start the ball rolling and make another appt. for exactly 30 days. Always show some kind of effort to improve your weight loss and have your doc document it on your visit along with your weight. The 6 months flew by and it gave me time to do even more research and get alot of other things in order for my surgery.

Good luck. Jenifer

I also have BC/BS of MN.  I just wondered what you found out as far as approval with insurance.  I have been going to my doc for my 6 mo approval since Jan of this year.  I skipped 3 different months so I have to keep starting over.  The insurance company told me that It doesn't have to be consecutive months but surgeon's office told me it did.  Anyway My PCP didn't document our conversations about what I was doing each month to lose weight, example..exercise, goals and lifestyle modifications.  I am hoping to be aproved just because I've been going to him for so long and my weight has gone up and down.  I am worried about it now!  Sorry my anxiety is getting to me and I'm just doing MORE research!

Thanks for any help!
Kim

Hi Kim,

I basically saw my doctor in February and didn't see him again until July, but I was doing weigh****chers during that time. Last week I got him to fill out 6 forms that had checklists for what type of diet I was following, how much to exercise, any behavior modifications, etc. For the months I didn't see him, he used my weight recordings from weigh****chers. I have this form if you would like me to email it. Insurance would not move forward without the 6 months documentation. Anyway, they faxed the forms to insurance late Wednesday, and called today to tell me I was approved. They already had everything else, they were just waiting on those forms. I don't think they actually needed 6 documents, but they did want specific notes regarding weight loss attempts. If your PCP will just go back and fill out a form for each visit, you should be fine. I really had no trouble at all. Let me know if you have questions, or if you want me to email you that form.

Thanks,
Amy

Thank you so much!  I would appreciate the e-mail. my e-mail address is [email protected].  I have a form here but since you have already been approved with your form, I would like to use it.  I got a letter of recommendation from my PCP and weight, b/p, etc...when I visited him and he even sent me to a nutritionist. 
So do you think it would work if I filled in what I have done during the 6 months on the 6 forms and had him sign them?  Or maybe I can give him 6 months of documention and he can write them up himself and sign them?  What do you think would be best?
Again, I really appreciate this.  Its 1am now maybe I can sleep tonight.
Hope to hear from you soon.
Kim

Hey Kim! I hope you got some sleep. I know I will certainly rest easy this weekend now that I finally have approval. I sent you the form from my personal email ([email protected]). It sounds like you have done plenty so you really shouldn't have any problem. I would just fill out the forms and have him sign them. Insurance was really not difficult at all. Good luck and let me know if you have questions!

Amy