Recent Posts

Girl_in_green_dress
on 12/12/16 11:59 am - Louisville, KY
VSG on 10/16/17
Topic: RE: Wording of requirments

Nope nothing. someone at the surgeon  office is going to look into it after I see my new pcp and get some paper work turned in to her. ill let you know if anything is clarified!

beccakevinmom
on 12/12/16 11:42 am - wallingford, CT
Topic: RE: Wording of requirments

Hi - curious if you got your answer?  I have my appointment with my surgeon in mid January - my dr knows I have been trying to lose weight and have been up and down since I met her - I would just HATE to have to wait 6 months to prove I cannot lose weight!! 

267/258/223.9 Turkey Day Challenge 15 pounds minus 2.1lbs
Highest/Surgery/Current

Tayfusion2
on 11/5/16 7:00 pm
Topic: Molina healthcare Medicaid of Illinois

Hi, Does anyone know the requirements for RNY surgery under Molina healthcare of Illinois Medicaid? Please help. Thanks.

Girl_in_green_dress
on 10/27/16 2:04 am - Louisville, KY
VSG on 10/16/17
Topic: Wording of requirments

Years ago (2011) when i first started the process for bariatric surgery (got talked out of it, long story) the wording of my insurance policy was "doctor supervised diet". 

 

I have a different insurance now, BCBS of TN and the wording is alot different. 

 

  • Attending physician documents adherence to a non-surgical weight loss program (e.g. dietary management, behavior modification, and/or exercise) with ALL of the following:

    • Most recent attempt was within 2 years of request for surgery

    • Participation was for a minimum of 6 months.

 

Can anyone tell me if this is the same thing, or if they just have to say yeah they have done this this this and blah of # months.

 

I tried asking the nice BCBS service rep for clarification, but she said that's all it said. I have my consult in december. But I have had some hiccups with my PCP retiring our of no where, and the area I live in has a doc shortage, so it's been one thing after another. 

 

I had read a few places that some BCBS networks had changed to not needing a "supervised diet" and just wondered if this was the wording for that.

 

Thanks for any help

Jwy
on 9/4/16 6:35 am
Topic: Insurance for surgery in brazil

does anyone know if it's possible to get insurance that covers complications for surgery in Brazil?  I have seen it for surgery in Mexico but nowhere else

Firstlady1726
on 8/31/16 8:46 pm
ReShape on 10/03/16
Topic: RE: Appealing Panniculectomy Denial

Hello Mrs. Judy B. would you please send my a copy of the letter. I was recently denied with UHC and I would like to appeal and don't know where to start. I would love for them to approve my first appeal. I would great appreciate it if you can help me out. UHC covered my gastric but said panniectomy/ abdominal plastic is not covered! HELP PLEASE THANKS 

Mamamarygoldy
on 8/4/16 7:34 am
Topic: General insurance inquiries

Hi everyone. I have Blue Cross NY, as a state employee. I have a BMI of 36, but not really any como's... I only need one to qualify. I do have a documented cardiac arrhythmia, but it's really minor. Anyone have experience with this type of insurance, and getting approval, especially for this comorbidity? I just don't want to waste any time. Thank you all in advance. Also, if anyone can explain the psych evaluation, that would be amazing. 

EmiLou1989
on 5/24/16 8:37 pm - Columbia, SC
Topic: Insurance question? SC Medicaid? Blue Choice?

Wondering if anyone in SC has Blue Choice medicaid and whether or not you had to go through the 6 month diet before being authorized to have surgery?

adunn3
on 5/16/16 11:00 am
Topic: RE: Blue Cross Blue Shield of MN questioms

PS Congrats on your approval!!!!

adunn3
on 5/16/16 10:58 am
Topic: RE: Blue Cross Blue Shield of MN questioms

Thanks so much for your response.  I have met with a bariatric surgeon and his team.  I think I am just overthinking everything and am really anxious about getting an approval when the time comes to submit everything.  When I went to the new patient seminar, they did mention the items they would need from me to get an approval and medical records was not one of the items.  I was pretty much told the same as you.  I was reading other post and someone mentioned the whole medical records thing and it made me wonder if I would need the same. Like I said, I think I am just anxious and overthinking everything.  Especially since I have a 4 months left on my medically supervised diet.  Lots of time to overanalyze.  lol 

 

Again, thanks for you response.  

 

 

Most Active
×