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Few Questions on required testing and insurance



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Ok...I have BCBS of Alabama. I am 4 months into my 6 months supervised diet. I am scheduling all of the testing that has to be done and I have some questions. First of all, I saw my bariatric surgeon a couple of months ago and my insurance claim for that appointment got denied b/c the insurance hasn't approved me for the surgery yet. My question is...do I have to pay out of pocket for all of these tests (psych eval, nutritional eval, labs, etc.) since I haven't been approved by BCBS yet? I called BCBS and that can't say for sure b/c they don't know how these places will code the tests. Anyone with the same experience?

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That doesn't make any sense. You have to see the surgeon first so they can submit a request for the surgery, so they definitely should have paid for that office visit, I would fight that. I had to pay out of pocket for the psych eval but my nutritionist is included with my Dr visits. You may have to wait to get approved before you do any labs or other tests though or they may not pay for that. But definitely fight the doctor visit.

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I have BCBS (basic federal) of Illinois and I didnt have to pay out of pocket for ANY appointments. Only co-pays thru the whole process. I would fight that for sure.

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No, I haven't had the same experience....yet. I'm just getting started, but I have BCBS of Alabama through my university, and am worried about what they will cover. My first appointment with my surgeon is in 2 weeks I haven't started the 6 month supervised diet yet. Did you have to find your own supervised diet program or did your surgeon recommend one?

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No' date=' I haven't had the same experience....yet. I'm just getting started, but I have BCBS of Alabama through my university, and am worried about what they will cover. My first appointment with my surgeon is in 2 weeks I haven't started the 6 month supervised diet yet. Did you have to find your own supervised diet program or did your surgeon recommend one?[/quote']

I have BCBS MS and I'm a State Employee. I had to pay out of pocket for my consultation with the physician, as well as weight management appointments. The physician's office did submit the claims do they can count toward my deductible. I have to meet my $1,000.00 deductible before BCBS will start contributing their 80%. I hope this helps.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      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. 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.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

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

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