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Does anyone have BCBS blue advantage? I have to attend 8 months of dietary classes.

I just started this process. My PCP referred me to the NUT. I saw her today and she told me thAt my medical group (Hammond Clinic) requires I attend 8 months of dietary meetings then they can refer me to the surgeon & then he will submit the request to the insurance. Since it is an *** everything has to go thru the medical group. This is very confusing. I am still not clear who approves the surgery or why I have to attend eight months of classes. My fear is that I will attend the classes and they will turn me down. I am 5.5 tall. I have a BMI of 36.8. I also have high blood pressure & cholesterol, sever arthritis in my back & I am going for a sleep apnea test.

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Call your Insurance and ask what the requirements are. I swear those dietary meetings do not sound like they will be covered by insurance and will have to be paid out of pocket by you.

I agree. Call your insurance and YOU find out what they want.... :) I have a diff BCBS and all I needed was some basic tests and 1 nut and 1 psych. visit.

  • Author

Since my PCP gave me a referral the meetings are covered. I wish I had a ppo. But I have an H M O. I called bcbs and they told me it was up to the medical group I am with (Hammond clinic). I think I am going to call back because my friend had surgery today, he had an H M O. He started the process & finished In less then two months

Can you change medical groups within your ***? If so, maybe you could research first and see who doesn't require quite so much. I have to do 3 months at Kaiser

I have bcbs ppo and they just have to see that you are trying. They need release from nutritionist and pscy eval. If you need those classes, ask whom ever is running the program or your doctor for the procedure codes. Then call bcbs and ask if those specific codes are covered. My doctor gave me some codes so I could check. The nutrition classes were covered as long as there was a qualifying diagnosis such as diabetes and obesity. For the 1on 1 visits with the nutritionists, bcbs only covers 4. I am here in California and I am not sure if they are the same for all their different plans. So as mentioned earlier get those procedure codes if you can and then call bcbs.

Medical groups are a trip. Some are really good and some are really bad. I would get online and search for providers that way you can find all the different medical groups. Find the bariatricts surgeon for that group and call them. They should either transfer you to the office manager or the person who handles submitting pre auths to insurances. They can tell u the requirements. If your friend has the exact same insurance you have, ask them the medical group they belong too. With ****H.M.O you can switch groups but, it will take effect the 1st day of following month.

  • Author

I am going to call BcBS today. I think I have to switch medical groups. Thank you all so much!

Best of luck!

  • Author

I called bcbs and they told me that my medical group has the right to make the decision on how long I must be on a medically supervised diet. I thought of switching groups but I'm worried if I do it will take just as long.

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