Longshot Question about insurance

rivieramaya05
on 10/4/13 7:07 am - TX
VSG on 12/16/13

I realize theres a good possibility no one will know the answer but I have BCBS. My insurance requirements  with them for a revision include a psych consult, nutritionist and 3 months of a supervised diet. I have a "in" with my surgeon (he works with my husband) and am wanting to have the surgery done before the end of the year because I've met my deductible. The kicker is the 3 month diet. So here is my question. Last year I visited a doctor who tested me for everything because I was unable to lose weight with my band so I was hoping it was a chemical issue. We also did a supervised diet for 6 months. What are the chances of the insurance company accepting that even though it's a year ago?

The bariatric coordinator told me to go ahead and get the records and she'd try to submit them to see.









 

noftessa0401
on 10/8/13 7:18 am - San Diego, CA
RNY on 12/27/12

I'm sorry no one replied to this.  It really depends on each insurance company.  For example, Aetna requires that the 6-month supervised happen within 2 years prior to the surgery.  They have a 3-month option that they require happen within the 6 months prior to the surgery.  It appears that BCBS's medical policy bulletin is silent as to the timing, so, you might make it.

HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"

M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)

rivieramaya05
on 10/8/13 7:22 am - TX
VSG on 12/16/13
Thanks for the reply! Hoping for the best









 

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