Savedbygrace

Nina - Here is the policy for BCBS of AL. It looks like it's alot alike other than BC requires 6 COMPLETED months before submitting for approval, it also has BMI requirements, as most do. Is BCBS your primary or Aetna. NORMALLY... the secondary follows the primaries guidelines. I would call and ask the insurance company if that is so in WLS. https://www.bcbsal.org/providers/policies/final/053.pdf

Hi! What questions do you have? I've been approved with BCBS of AL. Not sure about the requirements of Aetna but will be glad to help if I can. I am in Huntsville also.

Do you know who host that support group? Is it affiliated with a surgeon? I am looking for a location to start a group. I was just wondering if the hospitals allow only doctor affiliated groups to use their facility. Thanks!

I'm not sure it would help any more but i gave them EVERYTHING I had. It can't hurt. You did the WW 16 months straight? Where they within the last 24 months? If so that's awesome. Shouldn't have any problem as long as your BMI for the last 3 yrs qualifies.

I have BCBS of AL PPO. My records showing bmi for 3 years came from 3 different doctors. I was approved. Good luck!!

Any April bandsters here?

What type facility is your support group in? We need to get one started here but have no idea where to hold it. My church is about 15 miles from the main town - making it about 30-40 from some of the people who would come. Any suggestions?

What all are you all doing to get ready for the surgery? The lifestyle change? Have a shopping list for preop shopping? Already joined gym? Figured out your favorite protein shake? Any tips you've learned??

i had 2 that were faint -just like this and from dollar general and was pregnant.... just very early.

From my understanding, Shawna is right. I was very impressed with Dr. Miles' group. A seminar is very informative and required as well. Goodluck!!

Unless something changes, I am scheduled for the nutrition class April 9th also. I really hope this class helps!! (Gives step by step what to expect ... cans and can'ts etc) See you there!!:biggrin2:

Thats what I was told too. If you are diagnosed with sleep apenia, they require you to take the CPAP with you to surgery. I'm not sure if they automatically put it on your or just have it for stand by. What I wondered is why if it's required for this surgery... why not every surgery. I've been put to sleep several times and was never asked this. Maybe its due to the location they are working with. The sleep study wasn't really that big of a deal... I just hated it because I knew they were watching me on a camera and the bed was VERY uncomfortable.

Congrads on hearing back from her and getting the date set!! Are they booked up until May?? Mine is set for April 24th but we are thinking of taking a company trip to vegas that weekend so I was thinking of changing it but haven't confirmed the trip yet. I wondered when it would be rescheduled to if I asked. sleep study... I was required to do that too. HATE every minute of that night but was willing to do whatever it took. It was required by Dr. Miles, not my insurance.

Praying for you!! Even when we cant trace Gods hand, we can trust His heart!

What a whack!! Can't wait to hear from you after todays appt!

Congrats on the approval!! I had faxed my paperwork in to Neomi and a week later I called to make sure they got it because I never heard anything. When I called, she told me I had already been approved. So ... that was around March 7th and my sugery was set up that day for April 24th. I have to go April 9th for the nutrition class that is required and then back on the 18th for preop testing. About 2 weeks later, I got the actual approval from BCBS in the mail. If I were you, I'd call. I've emailed twice since then and haven't heard back either. I'm sure they are very busy bc I used to hear back within the hour but haven't on the last 2 emails. Let me know your date when you get it!! Good luck!!!!!!!!!

Can any of Dr. Miles or Schmitt's patients help me with a few questions I have? I have BCBS of AL PPO. How much where you required to pay upfront? (with insurance) What was the PREop requirement? (liquids for so many days etc? What is the POSTop requirement? (liquids so many days, mushies.. etc) I think that's all for now. We have a couple of vacations coming up and I would like to have a heads up on the money so I don't spend it on vacation lol and food requirements..... same.. need to be sure vacation goes along with them. Thanks!!

Is it an hmo, ppo, etc? Although that's where headquarters is, if the offer you ins in NJ you should be able to use it locally! We have patients that come for prosthetics and they have BC of IL, BC of GA.... etc and we're in Alabama. I'd just ask them for a list of surgeons in your area.

Congrats!!!!

That IS crazy! I have bc of al also and wasn't aware of that. I wonder if we get a year of fills or something with the initial payment from bc. When I was at Dr. Miles seminar, if you paid cash, the first year was included. I sure hope that's the case with ins too. I've heard that the fills are quite expensive!

Any word Missy? I have BCBS of AL and using Dr. Miles too!

It depends on your insurance's guidelines. Some want your past weight back 3 years, some want 5. Anything past that number of years shouldn't matter to them. From all insurances I've looked into, your BMI must be 40 or above ... or 35-39 with comorbids. Good luck!!

Congratulations!!

I looked at their website to see if I could find their medical policy - which usually tells you what you must do to be approved. Bad news is I couldn't find that but good news is that they have a brochure on there about WLS so that's a sign they DO cover it. Call and ask them what you need to do. Good luck!!

Congratulations!!!!!!!!!!