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

Horizon Blue Cross Blue Shield NJ Experiences?

LumpySpacePrincess

By LumpySpacePrincess, in Insurance & Financing

Recommended Posts

LumpySpacePrincess    594

LumpySpacePrincess
Posted

Anyone have any experience with submitting to them, how long it takes to get a response, approval rate? From what I'm finding (and what the insurance coordinator for my surgeon says) they seem to be approving a lot of people very easily right now. All of my pre-op work is done, except the last consult with my surgeon before surgery and setting a date.

Let me know if you have any experience with them!

Share this post

Link to post
Share on other sites

JerseyGirl68    1,172

JerseyGirl68
Posted

Hi There,

I also have HBCBS NJ. I was sleeved last December. Last summer they required a 6 month supervised diet, but right when I started my process, they did away with that requirement. They submitted on a Thursday and I believe it was just a week until I found out I was approved for surgery. Very smooth process with the insurance. I went out of Valley Hospital and the coordinator was very knowledgeable of the system. I don't know percentages, but if you meet the criteria and have all the docs in place you should be golden. After they submit, give it a few days then you can log into your account online and see if it has gone through the system yet. Or give them a call.

Best of luck!!

LumpySpacePrincess reacted to this

Share this post

Link to post
Share on other sites

Tikvah    70

Tikvah
Posted

Jersey, do you remember what docs and info were submitted to horizon bcbs? I have them as well.

Share this post

Link to post
Share on other sites

LumpySpacePrincess    594

LumpySpacePrincess
Posted

Hi There,

I also have HBCBS NJ. I was sleeved last December. Last summer they required a 6 month supervised diet, but right when I started my process, they did away with that requirement. They submitted on a Thursday and I believe it was just a week until I found out I was approved for surgery. Very smooth process with the insurance. I went out of Valley Hospital and the coordinator was very knowledgeable of the system. I don't know percentages, but if you meet the criteria and have all the docs in place you should be golden. After they submit, give it a few days then you can log into your account online and see if it has gone through the system yet. Or give them a call.

Best of luck!!

Thank you, Jersey! :) That's interesting because I am also going through Valley (Dr. Bagloo)! What did you think of the actual procedure with them? How was the hospital itself? I know at Holy Name Hospital they have individual monitors where you can go online and watch tv to be "entertained" while you wait or to distract yourself. Anything like that at Valley? I know I probably won't care when I'm all doped up, but these things cross my mind! Please share your Valley experience!! :)

Share this post

Link to post
Share on other sites

JerseyGirl68    1,172

JerseyGirl68
Posted

Jersey, do you remember what docs and info were submitted to horizon bcbs? I have them as well.

I had to submit a letter stating why I wanted the surgery and detailing my past weight loss efforts. It included a "weight" history from my primary doc. They really just wanted to see that this was a long term problem I guess. There was testing required: EKG, Endoscopy, bloodwork. But nothing too out of the ordinary.

Share this post

Link to post
Share on other sites

JerseyGirl68    1,172

JerseyGirl68
Posted

Thank you, Jersey! :) That's interesting because I am also going through Valley (Dr. Bagloo)! What did you think of the actual procedure with them? How was the hospital itself? I know at Holy Name Hospital they have individual monitors where you can go online and watch tv to be "entertained" while you wait or to distract yourself. Anything like that at Valley? I know I probably won't care when I'm all doped up, but these things cross my mind! Please share your Valley experience!! :)

My surgeon is in the same practice with Dr. Bagloo, and I have heard nothing but good things about her. My surgeon was Dr. Schrope. I was completely impressed with Valley. The care was fantastic. The surgical waiting room was comfortable with individual televisions and I could have someone there waiting with me until they brought me in. They were very attentive, and kept bringing me warm blakents. Internet connection was spotty in that waiting area. But other areas it was fine. Unless this has changed, all surgical patients had a private room, which was nice. I did not have to ask for a single thing while I was there. The day I had my surgery there were quite a few of us recovering from sleeve surgery. The floor itself was quiet and I got plenty of rest.

They don't wake you in the middle of the night like some hospitals, unless you have special or unusual needs, they will round before you go to sleep.

I highly recommend the practice and the hospital to anyone that asks. The followup I have had is great. Everyone there is very helpful. My nutritionist is Meredith Urban. Another rave review from me about her.

When is your surgery??

Share this post

Link to post
Share on other sites

LumpySpacePrincess    594

LumpySpacePrincess
Posted

My surgeon is in the same practice with Dr. Bagloo, and I have heard nothing but good things about her. My surgeon was Dr. Schrope. I was completely impressed with Valley. The care was fantastic. The surgical waiting room was comfortable with individual televisions and I could have someone there waiting with me until they brought me in. They were very attentive, and kept bringing me warm blakents. Internet connection was spotty in that waiting area. But other areas it was fine. Unless this has changed, all surgical patients had a private room, which was nice. I did not have to ask for a single thing while I was there. The day I had my surgery there were quite a few of us recovering from sleeve surgery. The floor itself was quiet and I got plenty of rest.

They don't wake you in the middle of the night like some hospitals, unless you have special or unusual needs, they will round before you go to sleep.

I highly recommend the practice and the hospital to anyone that asks. The followup I have had is great. Everyone there is very helpful. My nutritionist is Meredith Urban. Another rave review from me about her.

When is your surgery??

No surgery date yet. Waiting on the insurance approval, and the packet went out this morning! I love Meredith! Such an easy going nutritionist; her plan is so easy to follow!

Thanks for the info on the hospital! Sounds really fantastic and I'm happy I chose Valley!!

JerseyGirl68 reacted to this

Share this post

Link to post
Share on other sites

Phillys1stlady    32

Phillys1stlady
Posted

Anyone have any experience with submitting to them' date=' how long it takes to get a response, approval rate? From what I'm finding (and what the insurance coordinator for my surgeon says) they seem to be approving a lot of people very easily right now. All of my pre-op work is done, except the last consult with my surgeon before surgery and setting a date. Let me know if you have any experience with them![/quote']

Mine took 24 hrs...but my friends took 3 days

JerseyGirl68 reacted to this

Share this post

Link to post
Share on other sites

LumpySpacePrincess    594

LumpySpacePrincess
Posted

The waiting kills me. I keep checking my Horizon online account every few hours to see if anything has come in! lol Going to be a long weekend if I don't hear anything by tomorrow!

Share this post

Link to post
Share on other sites

Phillys1stlady    32

Phillys1stlady
Posted

The waiting kills me. I keep checking my Horizon online account every few hours to see if anything has come in! lol Going to be a long weekend if I don't hear anything by tomorrow!

Have you called them? I called and received the news that way

Share this post

Link to post
Share on other sites

LumpySpacePrincess    594

LumpySpacePrincess
Posted

Have you called them? I called and received the news that way

No, I'll probably wait until tomorrow afternoon to call since everything was just sent in at 9am this morning. I know the squeaky wheel gets the grease but I'm almost afraid if I call they'll deny me for being annoying. haha

Share this post

Link to post
Share on other sites

mazzers120    75

mazzers120
Posted

No' date=' I'll probably wait until tomorrow afternoon to call since everything was just sent in at 9am this morning. I know the squeaky wheel gets the grease but I'm almost afraid if I call they'll deny me for being annoying. haha[/quote']

I know I was thinking that too, lol.

Share this post

Link to post
Share on other sites

Phillys1stlady    32

Phillys1stlady
Posted

No' date=' I'll probably wait until tomorrow afternoon to call since everything was just sent in at 9am this morning. I know the squeaky wheel gets the grease but I'm almost afraid if I call they'll deny me for being annoying. haha[/quote']

Although, I received the verbal approval...I just received the letter 3 days later...hopefully, if you call today they will have an answer

Share this post

Link to post
Share on other sites

LumpySpacePrincess    594

LumpySpacePrincess
Posted

Called and they told me they couldn't give me an answer over the phone and that "it may take up to 30 calendar days to process this request." I don't think it will take that long, but the waiting is excruciating! :P

Share this post

Link to post
Share on other sites

Phillys1stlady    32

Phillys1stlady
Posted

Called and they told me they couldn't give me an answer over the phone and that "it may take up to 30 calendar days to process this request." I don't think it will take that long' date=' but the waiting is excruciating! :P[/quote']

I hope u get an answer soon...I'm getting sleeved in 2 weeks on 11/4...so once you have it everything will move quickly

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

    • LeighaTR

      LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 1 reply
      1. Selina333

        Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

    • Alisa_S

      Alisa_S

      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.
      · 1 reply
      1. LeighaTR

        LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      Alisa_S

      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.
      · 1 reply
      1. summerseeker

        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.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

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

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 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!

    ×