BCBSNC

First of all, this is a very informational and helpful website.  I am in the process of starting my road to the LAP BAND surgery, and my BMI is 43.5, my question is does anyone know about the turnaround time for insurance approval.  I have BCBS Blue Options (PPO), and I'm ready to make that step for myself and my family.  I've attended the seminar at Davis Regional with Dr. Gary Robinson, and I am in the process of getting my medical records together.  I am just alittle scared to get my hopes up.  Please pass along any info or advice you may have for me..

 Hi and welcome.. I have BCBSNC and my plan is BlueCare..  not sure if one is better than the other.. but I don't have to pay any out of pocket money for the surgery.. which some do require that you pay something like 80/20.. and the people I spoked to at BCBS was very nice and said that if everything falls into place and everything seems to be in order and proper that of course it would have to be approved by the board but she said it will be fine.. they are a lot more aware of morbid obesity being a health risk now.. I would recommend calling them and going back to the website.. I moved from TN to NC in April of this year.. I started my journey in July as far as getting things in motion,, been researching for awhile but we had to wait for insurance to kick in and all.. and I've completed all the test and things that BCBS require as well as my doctor TODAY..and now all i'm waiting on is for them to turn everything in and wait for an approval.. so far I haven't had any problems.. and BCBS has been wonderful.. Hope all goes well and smooth for you..

I have the BCBSNC Blue Options also. I attended the seminar at Presbyterian hospital on May 21, 2007. During the seminar I received a information packet that explained the process. I called that week and made an appointment with Dr. Melkonian(June 7), During this samw visit a nutritionist did my evaluation as well. I also scheduled an appointment for the following week with a behavioral therapist. It only took about two weeks to complete said appointments and finalize my paperwork and bloodwork requirements. Since Dr. Melkonian is on the BCBS provider list, and his practice is 65% Bariatric they were experts at handling my approval with BCBS. They wanted to schedule my surgery for July 26. Since this was such a quick turn around I actually had to push the date back to Aug 16. I'm sitting up in my hospital chair right now and feel pretty good. I do think that Dr. Melkonian's experience and staff had alot to do with the speedy approval. Also Presbyterian  Hospital (Place of Surgery) is a BCBSNC  Bariatric Center of Excellence. That said I do believe it highly depends on your surgeon and their experience with this type of surgery. Dr. Melkonian doesn't do Lap-Band, his partner Dr. Lowe does. Hope this helps, don't give up Karla Brennan

Here is the link that maybe helpful for you, https://www.bcbsnc.com/services/medical-policy/pdf/surgery_for_morbid_obesity.pdf All surgeons required  pre-eval testing that has to be done before a clinic will submit your paper work, also for bcbs you have to get your  5 year weight history (which one can normally obtain from PCP).  Pre-testing alone can set you back a couple of months and cost you a pretty penny), then there is your intial consult with your surgeon that may take a Month or 2 depending how busy your surgeon is. I would look at around 3-5 months from start to Surgery day, unless you are self-pay, you can be on that table in no time. It is a process and I know that the wait is not easy but, well worth the education along the way and outcome. Good Luck on your journey to the new you. -Maryama

BCBS blue options ppo here...state plan......... I called first to verify procedure and my Dr. was ok with them.  My surgeons office required I pay my out of pocket, $1650 before I had the surgery.  My bills for the various testing were very minimal,,,,,some stuff I had already on file, ie:  mammogram, pap.  Once I had all the things together and they faxed it in, BCBS approved me the next day.  My Dr. said they usually are pretty fast.  I had a 41 bmi with 2 post morbidites.  Dont be afraid to call and check on your status once submitted, I'd give them a day or two and then check.  You might be suprised too! Nancy

What is a post morbidity? Tammy

I HAVE HIGH BLOOD PRESSURE AND I AM ON MEDICATION.

I have State BCBS.. and I was approved in one day.  The link provided gives you the conditions you have to meet in order to get your surgery.  :) 

Thanks for all the advice.  You guys are awesome and I feel like I've been forever, and I am looking forward to all the support and love that I feel already.  I will keep posting and reading so be on the lookout for me.  You've made me feel welcome!!!!!!!!!!