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highmark bcbs

Anyone else in the 6 month class journey for approval??

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  • I have highmark also did 6 mo dr visits, nut, and physiologist. I was approved in 2 days after it was sent in. Best of luck to you.

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  • Author

I have to call and schedule my psychological evaluation today then i have my last class this month...then go for my consult with the surgeon

I have highmark BCBS. I've been in a medically supervised nutrition and exercise program that meets WEEKLY since 2011. I provided office notes from my primary that she'd recommended the program, and we've discussed it during visits. They denied me because it wasn't six consecutive monthly visits with my primary. Pretty bummed because I've met the Intention behind the requirement.

Hi does anyone know if you are denied for bmi not being in plan policy requirements mine is 38 if you can appeal after gaining more weight?

  • Author

I am waiting for the psychologist to call me to set up my psychological evaluation........

  • 2 weeks later...

I have highmark as well. I am in my 5th month of diet program (about to start 6th). My coordinator told me that I had to go to 7 consecutive PCP appointments but she didn't say anything about a weight history of 2yrs. (i never went to the dr much) so I'm worried about this aspect. But after hearing all the great approval reviews I am praying :)

  • Author

i am in my last month the last class is the 23rd, i had my psychological evaluation this past Wednesday and she said i was a go on her end, and my consult with the surgeon is may 7th then they send everything to insurance.

Please let me know what they say. I have t had my psych appt yet. I also have to have a scope done, the dr thinks I may have a hernia. I am meeting with my NUT for the first time on the 24th. I have just been visiting my PCP since I live so far away from the hospital. I am praying they submit mine sometime in June.

  • 3 months later...

What kind of nutrition program did you go thru? And what did you and your dr talk about during visits?

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