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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?

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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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  • Author

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.

It is interesting, they told me to follow the benefits guide to a T. In the guide it does not mention the PMD letter...and it does say 3 months of nutritional or excuse me. It says at least three months prior to surgery date. I guess it can be interpreted many different ways. When I call they are not that helpful and tell me to just follow the benefits guide on fep.org.....It is kinda irritating that they are not more helpful.

BCBS of NC only required 2 consecutive years documented weight. It could be from your PCP, or any other documented visit to any doctor or even the ER.

It is interesting' date=' they told me to follow the benefits guide to a T. In the guide it does not mention the PMD letter...and it does say 3 months of nutritional or excuse me. It says at least three months prior to surgery date. I guess it can be interpreted many different ways. When I call they are not that helpful and tell me to just follow the benefits guide on fep.org.....It is kinda irritating that they are not more helpful.[/quote']

My patient advocate is the one handling all of it. She does it all the time. Asked her specifically, 3 months or 3 visits she was adamant 3 visits I even called fepblue and she told me the 3 things I mentioned. Maybe. Because my BMI is less than 40 with a comorbidity is why i need the letter from my doc.

  • Author

Yeah, I am overseas so even though the surgeon has worked with Fed patients before I am trying to make sure I dot my I's and cross my T's. I am going to call them for a 3rd time tomorrow...and see what I get. I have a year worth of medically supervised weight lose program reporting. I have had my first psych visit. I am finishing the surgeon's requirments tomorrow. Even though I don't need preapproval. I think I will send it in prior. I just got get my two year weight....which I am trying to get from GYN in the states.

BCBS of NC only required 2 consecutive years documented weight. It could be from your PCP, or any other documented visit to any doctor or even the ER.

You're right. I mistyped.

  • Author

I just emailed BCBS overseas assistance center. Maybe I will have better luck getting questions answered.

@SleevenChica...yes it my dog...he is no longer a puppy (will be 2 in December)...100lbs..what I need to lose ;-».

I found them very helpful when I would call fepblue. But, sometimes you get different info when you call again. My dr office has a coordinator that handles all of the insurance things. Sometimes, I think the delay in approval is that there are people in front of you that the dr office is helping. My dr office seems very busy but was always on top of everything.

I'm sure once you meet the basics it will go very quickly.

Let us know how it goes!!

  • Author

Yeah, I think being overseas most of it I have to deal with. As I was digging around on their website I noticed they have an overseas assistance center that I can email. I think that may be the way to go, so it is not I said they said. Thanks so much.

I love Labs and Goldens. I have to say it is probably the number one dog here in Colombia. My husband is so not a dog person, but I want one some kinda bad. My mom has a labrodoodle and I just heart him to pieces!

As long as you had a bmi of 59 you didn't have to wait and you where automatically approved. At least on my bcbs plan. And if your bmi was less you had to go through 6 months of doctor dieting.

I was told that if you apply to BCBS of Kansas that you will be denied because they don't cover any WLS and that after that, any kind of medical issue that you bill them for, like lab ect. that they will try to relate it to your wls and won't cover it either.

  • Author

Great news! I now have a coordinator that assists with procedures being done overseas. I feel so relieved. They have already sent me the initial form to get the ball rolling. I was feeling overwhelmed that I would have to do this on my own. So they issued me a case number and got all the information for the hospital here and for the surgeon.

The form is basic. Just ask if I had previous WLS and what programs I have tried. It asks if I have premorbidites....the doc will sign it and then I will send it back.

YEAH!!!

Great news! I now have a coordinator that assists with procdures being done overseas. I feel so relieved. They have already sent me the initial form to get the ball rolling. I was feeling overwhelmed that I would have to do this on my own. So they issued me a case number and got all the information for the hospital here and for the surgeon.

The form is basic. Just ask if I had previous WLS and what programs I have tried. It asks if I have premorbidites....the doc will sign it and then I will send it back.

YEAH!!!

So happy for you!

  • Author

So happy for you!

Thank you! It is such a relief.

This is my very first time to post..today I finally got my approval from bcbstx..its been a 6 month process..sent in the pre approval papers Tuesday and got the approval this morning(Monday). Got my surgery date for next Friday.. Tomorrow I start my liquid diet.:) bcbs was very helpful and I am super excited..

  • Author

This is my very first time to post..today I finally got my approval from bcbstx..its been a 6 month process..sent in the pre approval papers Tuesday and got the approval this morning(Monday). Got my surgery date for next Friday.. Tomorrow I start my liquid diet. :) bcbs was very helpful and I am super excited..

Welcome Lisa and good luck!!!

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