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indi1

Gastric Sleeve Patients
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Posts posted by indi1


  1. Well I called today to check the status and the nice lady on the phone said that it was not approved because they stated the paperwork only included 3 months of the 6 required. The lady on the phone pulled up all 38 pages and said that she saw all of it and they must have overlooked a page. Anyway, she "bumped" it back up to them saying they would see it in the morning and she would call me on my cell. So we will see tomorrow I guess. No matter how messy this gets I have to say that every time I have called BCBS, I have always spoken to the nicest people. Probably just jinxed myself:)


  2. I have BCBS-IL. I first discovered my surgical group through the insurance website. They were listed as a "blue distinction" center so I figured, I couldn't go wrong with that choice. The requirements for me were:

    6 month supervised diet with my pcp

    documentation from pcp that my bmi was 40 or 35 with weight related health issues

    Letter of recommendation from my pcp

    physiological examination (about an hour\30 or so easy questions)

    All of this was submitted to the surgical group this week by the pcp and submitted to insurance by the surgical group this week. Waiting..


  3. Thanks, I don't feel so bad now.I called BCBS and they said that when they approve it, it can be used at any surgeon in the network. I checked the next hospital that is a "Blue Distinction" Bariatric Center in the network. (Which is what I meant by "High Profile", I just couldn't remember what it was called at the time :) Unfortunately,they are booked as well. Tomorrow I will go further out and try the next one.


  4. I have finally started posting after lurking for almost a year! I have learned so much. In that time I have completed my 6th month supervised diet, all tests, visits, etc. Called my surgeons office last week to let them know my PCP was sending all the paperwork over and to expect it, so they could submit to insurance. They told me at that point they were completely booked till February. I was really upset as I had been trying to work with them and my PCP to squeeze this in this year. First reason is my work has a "lock down" period at the end of December into January, so my leaving at that time would be manageable when I returned to work. Second reason is that I have met almost all of my out of pocket expenses for this year with BCBS-IL and would have to pay next to nothing. Otherwise, it this doesn't happen till next year, I will have to pay a big chunk. I do believe this is worth any amount of money, but it just seems like that would be throwing money away because my surgeon is booked. I have spoken to his once for the consultation, but other than that, I don't see what other obligation I have to him.

    Question: If his office submits to insurance for approval, does that mean I have to have him do the surgery or is that approval good for any surgeon?

    I'm really thinking about contacting another surgeon as there are other "high profile" surgeons in the area. Just not sure why I feel so guilty about reaching out to another when I've only just spoken to him once.


  5. I also am in the same kind of situation. My work has a "lock-down" at the second half of December. Plus, to date, I have met just about all of my out of pocket expense with BCBSIL, so having the surgery this year would be the best financially as well. I have just completed my last 6 month supervised visit and my PCP sent the paperwork over to the surgeon's office yesterday. So I will have to follow up to see when they send it in to insurance, but BCBSIL told me the approval time was 7-14 days. When I talked to the the surgeon's office, they said they were booked till February. But would consider putting me on a waiting list of cancellations.(how many cancellations could they have :(). I have considered checking other surgeons in the area, but I wonder if this surgeons office gets the approval, does that mean that approval is only good for that surgeon?

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