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8 calendar days. My surgical coordinator called them daily. It takes a day for the faxed information to be logged and get to the nurse. In my case, the nurse then had it for 4 business days for some reason, and then it was referred to physician review. The physician signed off on it within 2 hours of picking it up the next day. My case was flagged for physician review because it's the RNY, and my BMI is between 35 and 40 with comorbidities.
I hope you had better luck than I, but based on my experience, it'll be a tough road.
Sleeved 6/12/13 - 100 pounds lost to get to goal!
Good Job.
My info was sent up to them (FEPBLUE) today. How long did you have to wait to hear approval?
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)
I'm APPROVED!
First submission with BCBS Federal. BMI > 35 with hypertension, mild apnea and a host of other comorbids that aren't in the bariatric trinity (Diabetes,hypertension,apnea).
I just want to say.. UP YOURS NALC!!!! (they denied me last year, would not forward my file to Cigna, and would not look at my clnicals quote on the phone.. .. "you're just taking blood pressure medicine"). I did get a sleep study after their denial to confirm mild apnea as NALC complained ... "you just have snoring.."
My advice to federal employees seeking this surgery with a BMI < 40.. stay away from FEHB insurance plans that have a middleman between the company and their underwriting insurance.. you will only wind up with two layers of bureaucracy to slog through to get approved.
on 1/18/13 2:17 am
I understand wanting the BLIS but a COE doesn't mean the surgeon is good. It really means they have a policy and procedure manual with all the right words in there. Some of the biggest bariaric butchers are COEs. Some of the best surgeons are not.
on 1/18/13 2:16 am
If it is excluded, they really mean it. WLS benefits are an additional premium for your employer. If that premium (rider) is not paid, they won't pay for your surgery.
MX can be a great option for self pay if you do your research.
on 1/18/13 2:12 am
Private insurance does not pay for WLS. They would go broke if they did. People would get a policy long enough to have them pay for surgery and then drop the policy.
Have you considered self pay in MX? Most people are self pay because most people do not have WLS benefits.
Pretty much all ins co's offer WLS, it's up to the employer to pay the additional premium for the WLS rider. It's very expensive.
Hockeymom87 · 0 replies · 662 views
