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Anyone From Nc?

  • Replies 44
  • Views 4.3k
  • Created
  • Last Reply

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Mines at Duke Regional as well but with Dr Torquati but I did meet Dr Sudan at my seminar!

I'm in Mooresville, BCBS of FL, 6 month physician supervised diet, approved in 11 business days, and Dr. Heider's patient. Surgery day 10/24.

I have my endoscopy tomorrow and then submission to BCBSNC!

  • 2 months later...

I am new TO NC and BCBSNC what were the requirements did anybody have to do the 6 month supervised diet?

  • 4 weeks later...

I am new TO NC and BCBSNC what were the requirements did anybody have to do the 6 month supervised diet?

I have BCBSNC. I called them before starting this process and was told I only had to have 6 mth of documented weight loss attempt. But it did not have to be submitted to insurance only my dr had to approve it. And this is what my policy states. My pre-op coordinator said the surgeon accepted my WW log because it was about 9 months straight within 2 yrs. So after going through all tests, etc. my file was turned over to the insurance coordinator for filing. She emails me the next day and says she cant submit without my 6 mths supervised visit & if I dont have it, I need to get started. I explained my policy doesnt require it only requires that my dr approved whatever I did and pre-op said dr approved it. She said she has been doing this a while and even if dr "approves" it doesn't mean insurance will, but she will submit "as is" if I request. I can't do 6 months supervised now because my policy renews June 1 & my deductible etc will apply all over again. We met our out of pocket is the only reason I can have to now. So it was submitted Friday. We will see. I hope she doesn't mess it up. Is bcbs asking for you to have 6 mths documented?

I am new TO NC and BCBSNC what were the requirements did anybody have to do the 6 month supervised diet?

I have BCBSNC. I called them before starting this process and was told I only had to have 6 mth of documented weight loss attempt. But it did not have to be submitted to insurance only my dr had to approve it. And this is what my policy states. My pre-op coordinator said the surgeon accepted my WW log because it was about 9 months straight within 2 yrs. So after going through all tests, etc. my file was turned over to the insurance coordinator for filing. She emails me the next day and says she cant submit without my 6 mths supervised visit & if I dont have it, I need to get started. I explained my policy doesnt require it only requires that my dr approved whatever I did and pre-op said dr approved it. She said she has been doing this a while and even if dr "approves" it doesn't mean insurance will, but she will submit "as is" if I request. I can't do 6 months supervised now because my policy renews June 1 & my deductible etc will apply all over again. We met our out of pocket is the only reason I can have to now. So it was submitted Friday. We will see. I hope she doesn't mess it up. Is bcbs asking for you to have 6 mths documented?

JWow1 I just had my consultation with the surgeon's office on the 28th I had about 8 months of attempts but was told per my insurance a 6 month supervised diet is apart of my requirements. My first of 6 appointments will be on the 25th of February. One thing my coordinator told me is that it has to be a consecutive 6 months if you miss a month you have to start over. To come this far and have met your oop max I really hope they will accept your attempts.

I am new TO NC and BCBSNC what were the requirements did anybody have to do the 6 month supervised diet?

I have BCBSNC. I called them before starting this process and was told I only had to have 6 mth of documented weight loss attempt. But it did not have to be submitted to insurance only my dr had to approve it. And this is what my policy states. My pre-op coordinator said the surgeon accepted my WW log because it was about 9 months straight within 2 yrs. So after going through all tests, etc. my file was turned over to the insurance coordinator for filing. She emails me the next day and says she cant submit without my 6 mths supervised visit & if I dont have it, I need to get started. I explained my policy doesnt require it only requires that my dr approved whatever I did and pre-op said dr approved it. She said she has been doing this a while and even if dr "approves" it doesn't mean insurance will, but she will submit "as is" if I request. I can't do 6 months supervised now because my policy renews June 1 & my deductible etc will apply all over again. We met our out of pocket is the only reason I can have to now. So it was submitted Friday. We will see. I hope she doesn't mess it up. Is bcbs asking for you to have 6 mths documented?
JWow1 I just had my consultation with the surgeon's office on the 28th I had about 8 months of attempts but was told per my insurance a 6 month supervised diet is apart of my requirements. My first of 6 appointments will be on the 25th of February. One thing my coordinator told me is that it has to be a consecutive 6 months if you miss a month you have to start over. To come this far and have met your oop max I really hope they will accept your attempts.

I hope so too! We'll see.

Edited by Jwow1

  • 1 month later...

I hope so too! We'll see.

Well, a bumpy ride!. Insurance initially denied me for the 6 month diet requirement. Saying it didn't prove surgeon reviewed it. So, I submitted to my surgeon all my DETAILED logs of food and exercise. (Already gave him my ww weigh in logs for 9 mths). I alsp typed a letter stating all the diets I've attempted in the past 20 years including the prescription pills I've taken (medically documented) and detailed my calories exercise and weight from ww. My surgeon did a peer to peer with the bcbs dr. He said the insurance company needs to see calorie info, not points so it was good I gave him a letter. Bcbs agreed I had seriously attempted and required me to do another 2 weeks log, come back to my surgeon, send in all the information I submitted to my surgeon along with a letter from my surgeon and they would review it for reconsideration. This info was faxed to them on Wed. and I was approved on Thursday. I go back to the surgeon on Monday the 31st to schedule my surgery! It was a battle and had to jump through some hoops but hope this is the worst part of the journey! Looks like I'm going to have an April surgery! So nervous.

  • 2 weeks later...

I'm in mooresville getting sleeved by dr. Heiden at lake norman regional medical center...paperwork should be submitted September 4 to BCBS IL..so hopefully approval soon after and end of September surgery date...fingers crossed!!! Good luck to everyone on their journey

I'm in mooresville also interested in dr Heiden. What was your experience?

I'm in southern wake county. For those of you who have already had surgery, did you still have doubts about whether you'd be able to stick with it long term? I feel like I've tried (and often did) lose weight countless times, but could never keep it off. Did you know you could do it before you pursued surgery or were you still worried about how you would be 2 years or more down the line. I am just starting the process- but if I'm honest with myself I have a horrible track record when it comes to food. Please tell me how you felt before you did this and how your outcome has been. Thanks :)

I'm in Charlotte but I'm having bypass surgery in Rock Hill, SC on the 21st.

  • 2 months later...

I'm in Greensboro getting sleeved on July 29th.

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