BLU CROSS BLU SHIELD PPO JUST CURIOUS!!!!!!!!!!!

JUST A QUICK QUESTION.  MY COUSIN HAD OPEN RNY IN 2000.  SHE IS INTERESTED IN A REVISION.  HAS ANYONE HAD REVISIONTHROUGH BLU CROSS BLU SHIELD PPO AND IF SO, HOW HARD WAS IT TO GET APPROVED?  DETAILS, PLEASE!!!!  THANKS IN ADVANCE.

Andrea,

I have federal blue cross blue shield and they approved my revision the first time it was submitted.  The important thing about getting approval if your bmi is under 40 is to prove there was a mechanical failure such as an enlarge stoma.  Also, be sure to call your insurance company to see if  they will approve revisions and if so what are the criteria.  Hope this help.

THANK YOU FOR YOUR RESPNSE. I'LL BE SURE TO LET HER KNOW.  THANKS AGAIN.

Hi, I just had revision surgery and have AZ BCBS PPO.  Have her go onine and read/print out the criteria for her plan.  Once all my paper work was submitted and a few questions answerd approval was done first time around.  All the best.

Cynthia

How do you find the criteria for a plan?

thank you

AZ BCBS has a web site and I obtained the criteria from there.  Call your ins carrier and get them to help you navigate the web site to find the criteria.

I have BCBS WNY and they told me that they do not have the criteria on their website for the insured to view, only for the providers.

Thanks so much,
Joyce

I see, so have your doctors ofc contact them and request a fax copy of the criteria.  That really makes no sense.  You may also have your human resource ofc contact them.

Hi there!  I was just approved for a revision through BCBS IL PPO.  I was denied the first time for lack of information, so my Dr's office got Obesity Law involved and it was approved in approx 2-3 weeks after submitting the information to their contact at BCBS.

 

All the best,

Elizabeth

What surgery did you originally have?  What do they actually do during a revision, if you know?  Is it the same surgery over again?  Any info you have that you don't mind sharing would help.  Thanks andrea