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Bcbs

How long did it take to get your approval?

If you were denied, did you appeal? Were you approved after the appeal?

Do you have BCBS/Federal or BCBS for a specific state?

  • Replies 44
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  • soccermomx2
    soccermomx2

    I have BCBS Federal too. Once I had everything...3 NUT appt (90day), PCP letter, history of weight & psych eval it took about 7-10 days for approval. You can always call insurance and ask if a

  • SleeveandRNYchica
    SleeveandRNYchica

    That is great news! Congratulations!!!!

  • valdostaGA
    valdostaGA

    Mine was sent to insurance yesterday so I'm still waiting!! So nervous! Hope I get a positive call by next week!

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I have BCBS Oklahoma but mine has a total obesity exclusion, so there was no hope of getting anything approved. So...I'm no help at all! :-)

  • Author

That so sucks Aaron! I know that BCBS differs from state to state, but I had no idea that they didn't cover it in some states.

I am interested to see the responses. I have Federal, but no preapproval needed since we live abroad. Interesting I know.....

I have BCBS

I have BCBS Federal also. I was told a 90 day NUT and had to have a pre- cert. I live in Ohio if that makes a difference. Have 2 more months till we apply.

  • Author

Yep, I have 90 day nutrition as well. Federal doesn't differ state to state. We all follow the regulations as stated on fepblue.org. I only differ with the preapproval.

I am just wanting to know on average how long it takes for people to get approved.

I have BCBS of Kansas and they don't cover any kind of wls period! So I'll be self pay.

I have BCBS Federal too. Once I had everything...3 NUT appt (90day), PCP letter, history of weight & psych eval it took about 7-10 days for approval.

You can always call insurance and ask if a precertification has been started. The federal program runs fast & they paid for everything.

I was very fortunate in that regard as well as the speed of the whole process. Feel free to ask me any questions about the Federal BCBS process...I'd be happy to help if I can.

I have BCBS of MI and they don't do any kind of pre-approval. They will give you and the doctor the requirements to finish and they will bill the claim once the surgery has been completed. Makes me nervous, but i didn't really have a choice. However, my doctor's office has been in touch with them a number of times, as have I, and they have assured me that with the proper documentation they do cover it.

Bcbs of Illinois my DrJoyce went to the state and fought use to be 6 months approval was a matter of weeks my delay is work giving me time off

I have BCBS of North Carolina that is specialized for the State Employees. Once I met all the requirements (approval from PCP, labs, psych, nutrition consult, seminar and pre-op consult) it only took a few days for approval! They required five years of documented weight loss attempt.

I have BCBSIL and my approval was within days. So many factors go in to it - how busy the department is, which could depend on the time of year, etc. My advice is to call until they see your paper work was received and then call until you have approval. BCBS does differ from state to state but also employers select what they want to cover and in many cases exclude bariatric surgery.

  • Author

Soccermom- Is that your dog??? He is adorable! I just love choco labs.....I pretty much like anything chocolate! Glad to hear your process was so smooth.

I have BCBS of Kansas and they don't cover any kind of wls period! So I'll be self pay.

I hate to hear the Bariatrics is still not covered by so many. But I am not surprised. I have been told by someone here it's like cosmetics. HA. I want to tell him to kiss it!

I have BCBS of MI and they don't do any kind of pre-approval. They will give you and the doctor the requirements to finish and they will bill the claim once the surgery has been completed. Makes me nervous, but i didn't really have a choice. However, my doctor's office has been in touch with them a number of times, as have I, and they have assured me that with the proper documentation they do cover it.

I am nervous too about not needing the preapproval, but I have to say, I did have breast reduction in 2003 no preapproval required if medically necessary. I can honestly say I was sweating bullets, but I didn't pay a dime. So I have a some faith that it will go smoothly this time as well.

BCBS of Iowa, at least 6 mo of Dr supervised weight loss/managemt. in the last 5 years.Was denied first then did the 6 mo turned this in & three days later had the o.k letter in my hot little hand.:)

  • Author

BCBS of Iowa, at least 6 mo of Dr supervised weight loss/managemt. in the last 5 years.Was denied first then did the 6 mo turned this in & three days later had the o.k letter in my hot little hand. :)

That is great news! Congratulations!!!!

Fed BCBS here. In the process told 3 nut visits...not 90 days.I will be done with those first week of sept. i have my PMD letter of medical necessity, had my psych visit. The psych visit, nut visits and the letter from my primary MD cover all the other required info. Thats all that they are requiring. The surgeon requires an ekg, labs and upper GI endoscopy. All done.

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