Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

BCBS of MI

onedaycloser

By onedaycloser, in Insurance & Financing

Recommended Posts

Nesa    51

Nesa
Posted

Thank you guys very much. I will definitely call first thing Monday. I work for a bank so let's see how that goes. Wish me luck!!!

Share this post

Link to post
Share on other sites

onedaycloser    136

onedaycloser
Posted

My NUT told me that the 6 consecutive visits with her would suffice....

Have a letter from BCBS that states the same requirements need to be met, hope there aren't any last minute surprises?

Share this post

Link to post
Share on other sites

Olarance75    215

Olarance75
Posted

I would call the surgeons office and BCBSM to ensure that NUT notes count. The medical policy states Dr. Notes. I wasn't able to use progress notes from sad kin complex and I went for 6 months last year and was seen by nurse. So please check with your surgeon and the insurance

Share this post

Link to post
Share on other sites

onedaycloser    136

onedaycloser
Posted

Will call Monday...thanks for everyone's advice really appreciate it.

Share this post

Link to post
Share on other sites

Nesa    51

Nesa
Posted

So my insurance now will only cover it if I have sleep apnea type two diabetes or some heart disease either one thank god I don't but I think I have sleep apnea lol so there gonna send me to test for that. I am borderline line diabetic but that's not enough unless my doctor prescribes me meds=(

Share this post

Link to post
Share on other sites

Olarance75    215

Olarance75
Posted

So my insurance now will only cover it if I have sleep apnea type two diabetes or some heart disease either one thank god I don't but I think I have sleep apnea lol so there gonna send me to test for that. I am borderline line diabetic but that's not enough unless my doctor prescribes me meds=(

the same applied to me. If your bmi is under 40 you have to have additional co morbidity issue. I have sleep apena

Share this post

Link to post
Share on other sites

Nesa    51

Nesa
Posted

the same applied to me. If your bmi is under 40 you have to have additional co morbidity issue. I have sleep apena

That's exactly what I was told that I need some kind of co morbidity issue. I'm not sure if I have sleep apnea I do have trouble sleeping but I'm not sure of that has anything to do with it and sometimes I gasp for air but that's not too often. I hope I don't get denied!!!

Share this post

Link to post
Share on other sites

Fixerupper    335

Fixerupper
Posted

I don't remember a lot about comorbidities. But did extensively document knee and back pain. I didn't have any comorbidities.

Share this post

Link to post
Share on other sites

Nesa    51

Nesa
Posted

I don't remember a lot about comorbidities. But did extensively document knee and back pain. I didn't have any comorbidities.

Did they accept your knee and back pain issues?

Share this post

Link to post
Share on other sites

Fixerupper    335

Fixerupper
Posted

Did they accept your knee and back pain issues?

Yes. They did. I went to the doc every time they acted up and had them prescribe meds for the pain.

Share this post

Link to post
Share on other sites

Nesa    51

Nesa
Posted

Yes. They did. I went to the doc every time they acted up and had them prescribe meds for the pain.

That's really good!!! =)

Share this post

Link to post
Share on other sites

Olarance75    215

Olarance75
Posted

Have your Dr send you for sleep apnea test.....

Share this post

Link to post
Share on other sites

Nesa    51

Nesa
Posted

Have your Dr send you for sleep apnea test.....

I'm scheduled for October 24 that was the only available date for this month.

Share this post

Link to post
Share on other sites

TP1    6

TP1
Posted

Does anyone know if the PATS testing covered by BCBSM?

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing Insurance & Financing

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×