? about preauthorization with BCBSTX

Blue Cross has recently changed their policy regarding WLS on September 15th.  I just read LAST NIGHT that they are now covering the DS for patients with BMI over 50 (which I am).   Up until now they only covered the band and RNY on  my policy.

I have been approved for the RNY and that runs out in December.  But I really want the DS.  So, my questions are:

1.)  If I apply for the DS and get denied will that throw out the approval for the RNY?  Will I have to resubmit for the RNY?  Or, will that approval still stand even though the other was rejected?

2.)  If I go ahead as if I am doing the RNY and they approve me before the surgery, will that effect much?  I have my second consult with the doctor on Thursday.  Either way I am doing something, but should I wait to hear from the insurance or just go to the appointment anyway?

Hi There!

I am was in the same boat that you are in. I was denied DS orginally...then decided have them submitt for RNY...Well I was approved for RNY...but with the changed 9/15. I had them resubmit for DS......Just a FYI, I was approved for the DS! I have BCBCIL FYI too.

Also I am going through some minor issues wht the approve for DS. I was told that one of the codes my dr gave was not a covered beneifit...this was for the LAP part of the DS.  So as for right now, I am approved for Open DS. My Dr is scheduleing a peer to peer with the insurance.

On BCBSIL policy states that they do cover lap...

Thanks for the information!  That is great news.  I have hope!

Called the insurance company today and they said that the RNY approval would stand if they denied the DS.  So it will not hurt to try.

The only issue I am having now is that the doctor I have is iffy on doing a revision from Lapband to DS and if he won't do it, I am going to have to find another doctor!  yikes!