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How long did you wait for approval from BCBS Federal?



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Just got my approval (Yay!). Just over two weeks from submission to approval.

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Congratulations!

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I have bc/bs federal. My paperwork was submitted as outpatient. When I found out about this, I called the dr's office and was told the insurance will not approve sleeve surgery for inpatient???? So they submit the request as outpatient and then get approval for two nights stay. I told them that the difference between inpatient and outpatient is significant. I was told it will be just fine, don't worry. That just didn't sound right so I called bc/bs and was told they approve the procedure based on what the dr says is medically necessary. If the approval is stated as outpatient, you are responsible for 15%. If the dr requests two nights for observation, you are still responsible for 15% of the entire cost.

Has anyone ever had this problem with billing? I believe what bc/bs is saying and think the dr's office just does the minimal paperwork to get the approval. I sent an email to the director of the bariatric center and am waiting for a reply.

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I got my approval yesterday when I called, yay!! it took exactly 7 days :o)

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Looks like I will be in this boat very soon.... starting to get nervous about the approval process....

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I had sugery 2 1/2 years ago with bcbs federal and I started the process at the end of Sept 2011 and had surgery Jan 2012. I had to go through 3 months of nutritional classes.

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I started the whole process in late May and was told I need the three months of counseling, psych eval and some other paperwork. Everything went like clockwork with only a small hitch with the paperwork submitted by my PCP. One call got that fixed in just a few minutes. The center called and gave me a surgery date the next day. I have not experienced any problems at all.

My surgery is 9/8 and everything is a GO!

I have FEP BCBS Standard and live in Eastern Virginia where there is a huge Federal Employee population and FEP Blue is considered a gold card policy.

Edited by Pictou

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Hi everyone! I have BCBS Federal, and I just got all my paperwork (psych eval, 3 months of doctor's notes, etc.) sent to the surgeon's office so they can review it and then submit to the insurance company. My first month of the 3 month physician weight loss program, I had a loss of a pound, then the second month I had another loss of a pound, but the third month I had a gain of a little less then two pounds. I'm so worried that my request will be denied because of that gain! Has anyone else had a similar experience? If so, were you approved or denied? Thanks!

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FEP BCBS didn't request weights from my meetings, just that I attended them.

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    • 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.
      · 0 replies
      1. This update has no replies.
    • 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

        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

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
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