bigbeauty78

I'm screaming from the mountain tops, doing the happy dance. Thank you sweet and wonderful God.. I had bcbsfl submitted yesterday approved yesterday ...
Best of luck to everyone.

I got approved today. I'm scheduled for 10/25.

My sleep study is tonight

That is fantastic. That is awesome that it was approved so fast too. Amazing!

Congrats. I have my sleep study tonight and the psychologist eval tomorrow. I should be ready to submit by next Friday. I can't wait!

I'm screaming from the mountain tops, doing the happy dance. Thank you sweet and wonderful God.. I had bcbsfl submitted yesterday approved yesterday ...
Best of luck to everyone.

I'm approved.

I'm screaming from the mountain tops, doing the happy dance. Thank you sweet and wonderful God.. I had bcbsfl submitted yesterday approved yesterday ...
Best of luck to everyone.

I'm screaming from the mountain tops, doing the happy dance. Thank you sweet and wonderful God.. I had bcbsfl submitted yesterday approved yesterday ...
Best of luck to everyone.

Whoohooo! Congrats!

congrats
patiently waiting

I finished all my pre op stuff last Thurs. My surgeon's office should be sending in anytime. Now I need to learn patience.
I already called insurance to see if it was submitted. Lol. Nope not yet

I just found out I'm approved. Oh my. Oh my ohy

oh you lucky duck! congrats. im climbing the walls waiting right now. whats that saying, a watched pot never boils? i say a watched phone never rings lol

No, I don't, sorry. I only know Aetna because that's the insurance I have & they sent me the link. You might try a Google or Bing search for BCBS bariatric surgery criteria, surgery for morbid obesity, medical necessity criteria & similar & see what comes up. I did find a few for BCBS when I was looking to compare criteria from different companies, but not Florida.
Remember that this is medical necessity criteria, not insurance contract coverage. First, whatever the service is needs to be covered by the contract. Then, even if it is medically necessary, if the contract excludes it, it would not be covered. Unfortunately, bariatric surgery is excluded in the contracts many employers purchase. That was always one of the most difficult things to try to explain when I worked as a clinical review nurse. Hopefully, now that obesity is classified as a disease in & of itself, surgical treatment will be an option for many more people.

I've met all my requirements and am ready for my file to go to insurance for approval. Please pray its quick.

Not yet hoping to make one tomorrow after I make my endoscopy appointment.

Yes on 8/21 almost a month. I didnt get a copay bill yet. Maybe $200? Dont know. Hospital charged 66k , GHI paid 1700 to Dr who billed 10k. Anesthesia and other Dr's who bill GHI i dont know yet. Dont Know how much hospital will get from bcbs. Its pending.

anthem calif care bc, submitted aug 28, approved 9/2. bmi 40, no comorbs
copay 100 per admit

Empire bcbs here. NYC.. Took 2 days Bmi was like 35, sleep apnea and Gerd.

I got approved today!

Insurance approved!!!!!! Yes!!!!!! Submitted Friday 4/12 - approved today 4/16!!

I am so sorry this happened to you. I would call your insurance company and ask for a written copy of their requirements. I know bc/bs for my plan had eliminated the 6 month diet requirement. Perhaps there was an error. I would make sure you get in writing the defination of 6month supervised diet. Then see if you can use some of the time you worked with the dietitcian toward that 6 months. I am so sorry the surgeon's office dropped the ball for you. I wish there was a way for them to "fix" their mistake.

I'm curious. I feel like keeping quiet about it because I don't want to deal with everyone's opinions about WLS and non-stop comments about my weight/diet. I'm generally a private person and don't want everyone knowing my business. I just want to drown out the noise and stay focused on my journey to good health and get support from fellow VSG'ers. Is this odd? Did you tell everyone? few folks? what were their reactions?

My insurance will count sleep Apnea as a co-morbidity if it is "severe". Mine is only "moderate". I am also pre-diabetic (taking Metformin to keep from getting full blown diabetes), and have high cholesterol, low thyroid and Gerd. I'm not sure if any of these are enough to claim as a co-morbidity by my insurance (BCBS of Alabama). I am a little above the 40 BMI, but haven't been always this big, just for the past 2-3 years.
Its going to be a toss up as to whether or not I get denied....but I'm planning to appeal my fingers off if they do!