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Showing results for 'Fed BC/BS'.
Found 17,501 results
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I have CA BLue Shield through my employer. I am in the last 3 days of my 6 month supervised diet. I have completed all of the tests. I am battling BS about one test that my surgeon required and BS does not want to pay for because they say that I did not have pre approval for tests required for Barbaric Surgery. I believe once I am approved they will pay. We submit Wednesday for approval. I will post when/if I am approved .
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Anyone with highmark bc bs? How strict about 2 yr history?
Dmog74 posted a topic in Insurance & Financing
Anyone with highnark bc vs? How strict are they about 2 yr history? The insurance policy reads 2 yr history of severe obesity. My bmi is just now 40. Last five years its been in the 35-39.5 range. Anyone have a similar experience with this? And I have no çomorbidities -
What were your unsuccessful weight loss attempts insurance needed?
tb21872 replied to bigbeauty78's topic in Insurance & Financing
I just had to have a statement from my Dr. that I had made previous attempts at weight loss and they failed. She typed up a statement showing dates I had come in to see her and that I had tried diet pills, phentermine, and was unsuccessful. I have BC/BS TX. It was a simple, brief statement. -
Hope this is the right place.. Will insurance cover if
rocknrollmama1980 posted a topic in Insurance & Financing
So I am 99.9 % self pay. My concern is what would happen if something went wrong. Like if I had to stay in the hospital as a result of a complication... Would Cigna pay for the stay even though it was related to something I didn't go through them for? Or what if 5 years from now my gallbladder is removed... Do I have to pay bc I paid for the surgery? Just wondering how that might work. -
Empire BC/BS covered my gastric sleeve, minus $250 in-patient co-pay. I had surgery on 06 Mar 15 at HMC-Pasack Valley and it was performed by Dr. Amit Triveti from Lap-Associates in Paramus, NJ.
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Hi I have anthem BC/BS of New England And I was told depression was not a co morbidity or joint pain ( bursitis ). I'm under 40 (39.1 bmi) and I'm sure I'll be in denial aisle when they call me. I'm still going through though:)
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I have a tendency to love the colors in my avatar and yes, I am hiding bc I don't feel comfortable with my face yet. I have developed a habit over the years to not look at myself and just do what I have to do.....Now having put this out there, I have noticed that when I see my body in the mirror, I love it, it's just that I believe I need a face lift to get rid of the baggy stuff. This is what I will be working on for now on......accepting the aging process. So my question is, Is this an issue with our body images and how do we challenge our beliefs on body image? This is a life time process and there are no easy answers. I will work on taking another picture of my body and post.....That is my first step. Give me 1 week time frame, I'm recovering from a cold and my eye lids are swollen and itchy.....wouldn't want to scare anyone out there! LOL
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Still Confused. WHO am I supposed to be seeing? Federal BCBS
NinaB replied to fluffytofit's topic in Insurance & Financing
I am also FED BCBS.. Pick a surgeon. Usually you do the supervised diet with them. -
BC/BS Federal. Sleeve surgery submitted as outpatient?
Nicie posted a topic in Insurance & Financing
I have bc/bs federal. My paperwork was submitted as outpatient. When I found out about this, I called the dr's office and was told bc/bs will not approve sleeve surgery for inpatient???? The dr's office told me they submit the request as outpatient and then after the surgery is done, they request approval for two nights stay. I was told it will be just fine, don't worry. That just didn't sound right so I called bc/bs and was told they approve the procedure based on what the dr says is medically necessary. If the approval is stated as outpatient, you are responsible for 15%. If the dr requests two nights for observation after the surgery, you are still responsible for 15% of the entire cost. So, if the surgery costs $50,000, I would owe $7,500 instead of just $250! Has anyone ever had this problem with the dr's office saying this is an outpatient only surgery for bc/bs and that is how they must submit the request? Does anyone know if it takes more paperwork to submit the request as inpatient? I am now really concerned that since the dr's office submitted the request as outpatient and it was approved, bc/bs will deny the inpatient request, if the dr's office resubmits. I sent an email to the director of the bariatric center and am waiting for a reply. -
Hello. I have Fed BC/BS basic. I paid $150 to the physician and $150 to the hospital. I did not pay anything else out of pocket. Just be sure (as stated above) that your Dr and hospital are in the network. It is wonderful insurance:)
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Baygirl... I'm not sure what you gathered from my post that made you assume what you clearly have assumed about me. I started my research last year... I was athletic in shape and in fantastic Health until having my daughter at 20. I've gained and lost over 100lbs multiple times in the past 9 years. It's been over a year since I began researching and talking to friends and strangers about the good the bad and the ugly and i made a decision... In January I went to my surgeons office for a consultation after THOROUGH research... I have been seeing a nutritionist, NP at the surgeons office, my primary MD, 4 specialists And monthly support groups as well as online support groups, this forum, and Private friendships I have built from these different sources every month since january. Including a walking group with pre and post op patients... When i started this post it was bc i met the actual surgeon... That does not mean i have not put in the time and research! I do not know what makes you the end all be all of WLS but I will tell you that 3 months after surgery I bet I will have complaints - and days will suck... But nothing has sucked more than being uncomfortable in my own skin since the day I became pregnant. I have fought the demons in my head for 9 years and this Is my last resort... I am ready. More ready than I bet you could say you were. And in 5 years when I'm whining about not having beer or getting divorced (which is ridiculous) - I hope you're off this website so I can get the support I need. People like you do not help. The good bad and ugly of surgery helps me and I cherish every post I see - but your post was stereotypical and an uneducated response to what clearly are your own problems... Not mine. I am the nicest person and I have been nothing but supportive on here. I haven't had one complaint about anyone I've met or spoke with on here until you.
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People, people, people. All companies are in the business of money. And insurance companies are the greediest. Their goal is to never pay out a dime. All this pre, pre, pre stuff is to get you to GIVE up or mess up and not provide some BS form or record they make up. Just keep trudging away and eventually they will run outa objections and have no choice but to approve it. Good luck.
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APPROVAL with HIGHMARK and a DATE w/ "Borderline" BMI!
missysue replied to twinRN's topic in Insurance & Financing
Good Luck!! Where in Pa are you located? I also have highmark bc/bs. I go for my sixth appointment the end of this month and then will submit. -
This is normal. I have a 5 year old daughter, single mom. I will be sleeve in May and kinda have this thought at least once a week. I've done the if I'm gone letter, the will, and custody if I die (bc I want my father to have custody instead of her horrible father). This is normal, and I talk myself out of the death scares lol. Just imagine the beautiful life your going to have with your children, and how not only you but your whole family will benefit from this change.
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Motivation and constistency
BandtoSleevechick replied to irisheyesrsmylng's topic in LAP-BAND Surgery Forums
HOnestly i think 80 pounds is a great accomplishment ... i am only one month banded... as for smoking congrats to you.. its a hard thing to do .. i quit 6 yrs ago but you can do it!! one day at a time.. i even stopped doing jenny craig when i quit bc i wantedt to concentrate on that and i gained all my 60 pounds back and then some.. if only i had the band then!! Please don;t feel like a failure i see a lot of hard work in the pounds lost and not smoking!! you can do it!!! -
I am just stopping by to introduce myself. I am very excited to have found this forum. I have not been banded yet but have begun the journey. I was just approved for surgery today after having my psychological exam. My next step is to meet with the surgeon. I have not officially heard if I have been approved for insurance but I meet I criteria, so I am hoping there will be no surprises there. I started this process 3 years ago only to find out that insurance would cover RYN but not the band. After the disappointing news I tried 1 more time really hard to lose weight and had lost 35 lbs, took me about a year, then started slowly gaining it back again. Fed up with the yo yo once more I called my insurance. Since then they have approved the band. Originally I had started the process with Dr. Malley in Kansas City, but when I started looking into it again he was 4 months out before I could even start seeing him so I did some research and decided to go with Dr. Hoehn. So far everything has been great and I am happy with that choice.:tongue:
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NEW PRODUCT ALERT: BariatricPal Clean Whey Protein
Alex Brecher posted a topic in Protein, Vitamins, and Supplements
A protein shake can do the trick before or after weight loss surgery, or any other time you need a boost of protein beyond what you can get from your foods. How do you find one that has the amount of protein you need, tastes great, and is low enough in carbohydrates to be good for any weight loss diet? Stop looking, because BariatricPal Clean Whey Protein is a match! BariatricPal Clean Whey Protein delivers 25 grams of high-quality whey protein in each scoop. It is made with real Dutch-process cocoa or classic vanilla and it tastes rich and creamy, but it has only 1 gram of sugar. The total carb count is 1 carbohydrate, meaning this shake can be part of your low-carb or keto diet. BariatricPal Clean Whey Protein Highlights: 110 calories 25 grams of protein from Grass-Fed Whey 1 gram of carbohydrates 500 million CFU Bacillus Coagulans Patented Aminogen® protein-digesting enzyme 10% of the daily value for calcium Suitable for gastric sleeve, gastric bypass, gastric band, and BPD-DS patients Suitable for pre-op and post-op liquid, pureed (mushy), semi-solid, and solid foods diets Gluten-Free Lactose-Free Non-GMO Each tub of BariatricPal Clean Whey Protein contains 15 servings. BariatricPal Clean Whey Protein has other advantages. It contains patented Aminogen®, an enzymatic blend to support the digestion of protein. Plus, the shake has 500 million CFU of Bacillus coagulans, a probiotic which can promote a healthier gut environment. BariatricPal Clean Whey Protein can be used anytime. Start the day off with a low-sugar burst of protein for breakfast, or have a quick shake for a snack or small meal later. Just mix a scoop with water or your favorite beverage, such as milk for extra protein, or almond milk for creaminess. With BariatricPal Clean Whey Protein, you can get the protein you need to tide you over, without taking in excessive carbs. What exactly is Aminogen® and how is it beneficial? Aminogen® is a special patented protein-digesting enzyme blend that can help you get the most out of your whey protein while eliminating any bloating or constipation. The addition of Aminogen® to whey protein, such as is done in BariatricPal Clean Whey Protein, is scientifically proven to improve digestion and retention of protein within the body. Another benefit of Aminogen® is that it reduces some of the gas, bloating, cramping, and constipation that can occur when some people eat a higher protein diet and include whey protein products. As some people know, this protein “gassiness” is not a pleasant side effect, so Aminogen® is a sought-after addition. Overall, Aminogen® is a valuable component to whey protein products, like BariatricPal Clean Whey Protein. It can help you digest and absorb more amino acids, which will then assist you in building and repairing your precious hard-earned lean body muscle. Available online at The BariatricPal Store https://store.bariatricpal.com/collections/bariatricpal-clean-whey-protein -
Liquid Diet Starts Today!
SuperFab replied to ddw12's topic in PRE-Operation Weight Loss Surgery Q&A
maybe. My nut is allowing it Bc so many of the others literally make me so sick I can't stay out of the restroom. Lol -
So I got banded on monday. Today is Friday. I was discharged Tuesday from the hospital in TJ. I had a feeling that what I am about to write would happen. Since Tuesday, right after I left the hospital I had one more question about the cream they prescribed for me and when I can take the bandages off...The hospital (though I have emailed 3 times and called) have yet to get back to me and answer. Instead, the MedToGo coordinator called some other doctor in the business and got the questions answered. Here is my point for those thinking about Mexico...what you get is what you pay for. They told me up and down at the hospital, "just call" "just email" if you have anything...what a crock of BS. I understand these doctors are busy and have busy days, however, responding to an email like that takes 3 minuts tops. It is a clear case of I paid them to do a service and they did...well and the business transaction is over. If any of this is something you don't want to be involved with rethink going to Mexico. In other news all is well (regardless) and I am under 200#s YAY!
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So I got banded on monday. Today is Friday. I was discharged Tuesday from the hospital in TJ. I had a feeling that what I am about to write would happen. Since Tuesday, right after I left the hospital I had one more question about the cream they prescribed for me and when I can take the bandages off...The hospital (though I have emailed 3 times and called) have yet to get back to me and answer. Instead, the MedToGo coordinator called some other doctor in the business and got the questions answered. Here is my point for those thinking about Mexico...what you get is what you pay for. They told me up and down at the hospital, "just call" "just email" if you have anything...what a crock of BS. I understand these doctors are busy and have busy days, however, responding to an email like that takes 3 minuts tops. It is a clear case of I paid them to do a service and they did...well and the business transaction is over. If any of this is something you don't want to be involved with rethink going to Mexico. In other news all is well (regardless) and I am under 200#s YAY!:frown:
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The latest and most definitely not the greatest!- I called Horizon BC/BS of NJ today to check the status of my referral/authorization. I had previously called and was assured that they had received my letter of Medical Necessity and was then given a case number. Silly me, I think having a case number will expedite things. Long story short, The first comment I hear after being on hold for about five minutes, is "Please don't be mad but"...Gotta love that. Apparently my letter didn't sprout legs and walk itself to the appropriate department--they will get that darn letter there pronto..... Crap like this, along with the extra weight keeps that blood pressure up!! I was assured (?!) that I should have an answer in 15 days, or by the end of the month. I hope she meant the end of this month.
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Hi everyone! I have been through all the processes necessary for surgery for my daughter. She is 14, 5'3" and 268 lbs. She has always been overweight and moved into the obese catagory at 3 years old despite a "normal" eating pattern. Well, Monday I verified that the insurance company, BC/BS of MN, had received the papers from the Doctor that included two psych eval's (just in case since she is bi-polar). I was informed that the case was in the medical review boards hands. Question....how long do I wait or how often do I call the insurance company to find out about approval/denial? I am anxious and hoping for the best (knowing deep inside we will probably get denied :phanvan ) but don't want to make the insurance company angry by calling too often. Any replies would be greatly appreciated. Thank you so much! Billie
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Hey Danny! From what I have "gleaned" from other posts, United Health Care is paying for more Bands than BC/BS...just an intuition...not based on fact at all. If you know the plan numbers, you can usually go online for coverage information. The CDT code for Lap Band is 43843. Good Luck!
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Hello Fran and welcome, I know what you mean about insurance. I have bc/bs Anthem and my husband and I pay 619.00 per month and they wouldn't cover so I was self pay, but, it was the best decision of my life. Don't you just love your band. I would part with my cell phone, satellite, and dog before my band, LOL. Welcome.
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I have only been banded for a week, so I have not had any fills yet but I hear the flouroscopy is better for finding the port. I am now praying it is bc you have me scared . I am not one for needles but if I was in your situation I would try the other way and if you can't you can always just say to yourself "it hurts to be beautiful". My mother used to tell me that when she was brushing my hair as a child. Now I totally see that with eyelash curlers and such tools she was right all along. :tt2: Good luck!!