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BCBS Fed response...



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My WLS doctors office submitted for pre approval for lap band last week. Saturday I received a letter saying it was denied. It stated I lacked documentation of per and post - operative nutritional assessment and counseling. My WLS doctor sent me to a nutritional class back at the end of Nov.

Anyone else have nutrition counseling? I have a call into the dr but just waiting on a call back.

Thanks!

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I had to attend a nutrition education class, in addition to the other requirements.

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I also had to meet with a nutritionist, just one time.

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they did the same thing to same insurance i got fed up and to tell u the truth thats what they want u to do at the time i was 24 i had and the agent was arguing with me and said if it wasnt for obama u wouldnt have insurance i was like whaaaat ##%&@#&# i want to speak with ur manager and this was me trying to get my medicine for surgery and they wouldnt approve it there going to give u hard time so u can give up and pay for it on ur own best of luck hope everything goes well !!!!

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I had to see a dietitian 3 times before the surgery and I also see her every time I have a fill. I just had my 3rd fill and saw her again.

Good luck with the insurance, they all have their own rules.

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We have BCBS Fed too and I had to go through a couple of things with them wanting more documentation from my surgeon's office. Fortunately, the insurance gal at his office is really good about making sure the insurance company gets every detail they ask for, so my paperwork finally made them happy and they covered it 100%. It may have just been a document that either didn't get sent initially, or they didn't see it in the pile or something. I'm sure your surgeon's office will help you clear it up. Good luck!

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I also had my surgery 3 years ago so that probably makes a difference on the requirements.

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I have BCBS Fed and got my approval in 7 days. I am working with True Results, which is like a chain clinic so I am guessing they have the system down pat. I spoke to the dietician at every one of my 3 monthly meetings.

Stay strong and keep at it. You and you doctor figure out what exactly you need to do next to get this done.

Do not give up or be discouraged.

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Thank y'all for the encouragement. The office called BCBS and the insurance lady said Ooooopppps our bad they pre approval has been rerouted back for review. Back to our regularly scheduled program of waiting. LOL!! But its not a no so I'm happy to wait!

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yep same thing with me n BSBS of ND. they sent me a letter stating they didnt receive the psych. eval. n the dieticians report. i called my case worker, she said she sent all that in together. she called them n they were like oh we dont know why he got that letter, hes approved n good to go. go figure huh. idiots

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Approved!!! Surgery set for March 21!!

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yay! Congratulations!

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I had to meet with a registered nutritionist one time as part of the process. I haven't been approved yet, but they did not accept the counciling from my doctor through the weight loss clinic. It had to be a nutritionist with BCBS-Fed. If you call them, they are really helpful though. We've (my husband and I) have called them probably 10 times asking questions. :)

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Just had my preop counseling today!! Two weeks and counting....

WOW!!!!!!

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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