I just got off the phone with customer service so I could find out my benefits and was told that after Jan 1, 2011 they where going to be tightening up their requirements for WLS and that in the furture patients will have to undergo supervised diet plans, ect, ect. The agent was a bit vague but now I am worried because there is no way that I will be having the surgery before that time. I could use advice about how to speed up the process.

Update: My doctor called this afternoon, and turns out that starting in the new year BCBS federal is requiring a 3 month supervised. I am SO frustrated! I'm really bummed out. I was hoping to get approved and have my surgery in early February .

Fortunately, they are including my previous 2 appointments with the surgeon as part of the 3 months--that means only 1 month left. I go for (hopefully) my last appointment with the NUT February 5. Then my paperwork will be resubmitted and I will wait and keep my fingers crossed.

It's so annoying because it is a complete waste of time. Just a delay on the part of the insurance company. Ugh!

O, I'm so glad its only 3 months cuz I already have that!!! I'm glad for you too cuz then you only have one more month!!! There is light at the end of the tunnel!!!

Stacy, that's awesome you have the 6 months. Hopefully, it is smooth sailing for both of u's from here

I'm actually trying to find another doctor right now. I'm very unhappy with the doctor I chose... they charge a $600 "program fee" above and beyond what they will be billing my insurance! So, I'm calling around to see which other doctors do NOT charge an out-of-pocket fee. I'm very disappointed cuz I would now have to start the process all over again!!! UGH!!

Just what do you get for a "program Fee"? I have BCBS Fed and didnt have to have any supervised dieting. Only 5 more days of no real food, I am completely miserable.

I think all doctors are different. This isn't something from insurance, its an out of pocket charge from the surgeon. Your lucky no supervised diet. I have to have 3mo

Status Update:

My paperwork was sent to BCBS- Fed on Monday, 24 Jan... I called BCBS and they said they should have approval/disapproval no later than Friday, 28 Jan. I'll let you all know how quickly I get an approval!!!

I have Fed BCBS. I went for my Psych Eval and consult with the exercise group on Jan. 5, 2011. I met with the dietitian and surgeon on Jan.12, 2011. All of my paperwork was submitted on Jan. 13, 2011. I received a phone call today, Jan 27, 2011 that I had been approved. I only have to do a monitored diet for two weeks before surgery and they said they could get me in as soon as three weeks.

Just got of the phone with insurance...the supervised diet I provided them is too old (3/10) and I need to have 3 months prior to surgery!!!! I'm so frustrated!!!! So now I have to wait another 3 months?!?! I tried calling the doctors office and only got voice mail!!!!! UGH!!!!!!

Lauren, that is so exciting. I hope to have my paperwork submitted to BCBS fed late next week. I hope my approval goes as smoothly as yours.

Congrats and good luck.

Paperwork was submitted today to BCBS Fed. Now I wait for approval---hope it goes quickly!

I have Fed BCBS. I went for my Psych Eval and consult with the exercise group on Jan. 5, 2011. I met with the dietitian and surgeon on Jan.12, 2011. All of my paperwork was submitted on Jan. 13, 2011. I received a phone call today, Jan 27, 2011 that I had been approved. I only have to do a monitored diet for two weeks before surgery and they said they could get me in as soon as three weeks.

does the ins pay for the dietician, psych eval, and 3 mo doctor monitored weightloss plan?

I sure hope you're right. I wont find out until after I complete my psych eval on 17 Jan 11.... Then once the surgeon receives the results, the paperwork should be sent to BCBS. I would think 6mo of a supervised diet plan is better than nothing, but someone else has said that they are actually getting stricter rather than more lenient.....Does anyone have experience with the new year?

3 months but proof of weigh 2 yrs thtas how I read it,,, but just a fed emp,,, not a ins atty like wee need to be sometimes

That is fantastic! I have federal BC/BS and have all of my pre-approval requirements into the surgeon's office. The insurance coordinator seems to be on the ball and I'm hoping for a surgery date soon. My BMI qualifies me and I seem fortunate that they only require 3 months of diet and exercise documentation from my family physician.

For what it's worth, there's another BCBS Federal thread in this category, and the approvals are coming VERY quickly. Once your surgeon's office has everything in, it appears they are granting the approvals within 3 days, and in one case within 1 and a half hours. Mine (once it was resubmitted to the correct fax number---grrr) was approved about 26 hours after the documentation was faxed in.

So if you can get your paperwork in from the surgeon, you very well may get your surgery before the new year! GOOD LUCK!

I am working on approval with Fed BCBS also. My surgeon's insurance coordinator is waiting for the notes from my former PCP regarding medical supervision of dieting. I was on phentermine from April to October 2009. Hopefully, they will accept that as the required diet. Otherwise, I will be doing 2 more visits with the dietician at my surgeon's office (1st one was August 18) and they will write up the report for the supervised diet for BCBS. My surgeon will be out of the office for the month of September, so my surgery won't be until October regardless.