Approvals with BCBS Federal

[nomoremeds 27]

That's what I was thinking the cooridinator would do for me,but she just told me that they could not give me a date without the apprival in office. They advertise that they have these top insurance negotiators but I'm doing all the leg work. Blue cross told me that they would resend the approval to them and mail one to me. I'm going to scan and email mine to them when I get it. I really like Dr. Holden and I want her to do my surgery. If it wasn't for that fact I would see if I could take my approval somewhere else.

[rln52 136]

When you scan it to them call and ask to be scheduled. I was scheduled once the nurse reviewed all my record to submit to insurance. Every clinic is different. Good luck.

[fluffytofit 25]

Hey guys, I also have federal BCBS. I had a question maybe you could help me with. Who are the supervised visits supposed to be with? Your PCP, nutritionist, or surgeon? Is the nutrition visit in addition to these visits? I called customer service, but she kept telling me to ask my PCP who I should be seeing. I saw my PCP for weight loss visits last year, Oct 2015, and Nov 2015. I chickened out, but I'm ready to continue, and will go back in August for another weight loss visit. Will the 2 visits from last fall count for my 3 months? The rep at BCBS told me my visits have to be 3 months before the surgery, specifically, she said if my surgery were in December, I'd need my 3 visits done in Sept, Oct, Nov. It doesn't sound right to me. She was even questioning it herself. Sorry, if this is confusing, I can clarify things if needed. Thanks!

[Oklahomagirl1970 4]

I had my 3 month visits in April, May and June by my pcp.. Then went for consultation with surgeon the end of June. I had went ahead during those 3 months and did my psych evaluation and the nutritional evaluation (as far as I know this does not count for your 3 visits) the nutritionist had to sign off and send it to the surgeon and so did the psych. My doctors office submitted my paperwork to bcbs federal in July and I got approved within a week

[liltextornados2015 4]

Weight loss is monitered by the nutritionist ie dietitian.. For 3 months. Buts it 4 visits total. (Initial, then 3 more) but the way inwas done

Was an initial visit w dr and then he gave me info for my nutritionist and then i went to go see her then when i was dome w her i went back to my surgeon and completed my requirements. In between i saw the psyc, and labwork, xrays and pcp(for follow ups and medical nes letter) thats how it was done w mine but every dr can be diff. Just ask them whats their protocol.

[nomoremeds 27]

All my nutrtional visits were done at the doctors weight loss clinic. The only thing I had to go elsewhere was for the psyc eval and the cardiologist.

[fluffytofit 25]

Thanks for all the replies. I think I am just going to do everything through my surgeons office. They do all of the visits right in their office.

[rln52 136]

My surgeon's office is next to my pcp's office so I saw pcp copay 25 for 3 supervised weight loss visits. They had to be at least 30 days apart no sooner and it could be a few days over. They filled out a form the surgeon gave me. I also had a nutritionist visit - no copay. I have BCBS Basic. I had EGD - 100 copay for hospital and 200 for surgeon and the psychologist eval. 35 copay. All in the same office and connecting hospital for EKG & Labs.

[SleeveandRNYchica 1,155]

It's funny how all of us have the same insurance but different costs based on surgeons office procedures.

I have my sheet at home and will give you my out-of-pocket expenses when I can.

[skinnytiff 49]

Dr Holden took out my gallbladder a year ago. Shes such a nice doctor and great at what she does! Dr Kim did my sleeve a ittle over 3 years ago.

That's what I was thinking the cooridinator would do for me,but she just told me that they could not give me a date without the apprival in office. They advertise that they have these top insurance negotiators but I'm doing all the leg work. Blue cross told me that they would resend the approval to them and mail one to me. I'm going to scan and email mine to them when I get it. I really like Dr. Holden and I want her to do my surgery. If it wasn't for that fact I would see if I could take my approval somewhere else.

[babbs2299 15]

I have BCBS (federal employee program). I have the one with PPO, not sure if it's called standard or basic. I do know it's the more expensive of the two. ???? I've started the process for my sleeve just within this month. My BMI is 41.7, I have sleep apnea but otherwise very healthy it seems. All it really is for me now is just a waiting game, and the insurance required 3 more appts, one of which has to be with the dietician. The surgery coordinator said we'll be scheduling the surgery on my 3rd visit. This is what was/is required of me for insurance...

1. PCP medical clearance signed that your safe for surgery and that the procedure is needed..........................completed and turned in

2. Psych. Evaluation which was a 40 minute session with a lady that had sleeve 6 months prior by same surgeon..............completed and turned in

3. History of weight loss attempts by me, how, etc. Basically a handwritten "weight loss resume"........completed and turned in

4. 3 month required waiting game that includes 4 official "visits" to the surgeons office, one of which has to be the dietician/nutritionist..........1 visit completed with the second one scheduled in about a week and a half and that's with the nutritionist.

That's all that is required for me to get approval. I'm hoping that I can get a late October, early November time slot for the table. Fingers crossed!!!

[rln52 136]

Good luck to you babbs2299

[babbs2299 15]

Thanks RIN52. It can't come soon enough.

[liltextornados2015 4]

I was also req to have 2-3 years of past history that includes/and states ive been overweight since 2012, 2013 2014? 2015 obviously doesnt count.. But ill double check cause one issue w that was due to my pregnancy. Idk if it was gonna be approved but ill check to see what dr included afterall? If he added prior another year or left it as is.. Ill look n post later.. Good luck to all

[ASUgrad 61]

I was also req to have 2-3 years of past history that includes/and states ive been overweight since 2012, 2013 2014? 2015 obviously doesnt count.. But ill double check cause one issue w that was due to my pregnancy. Idk if it was gonna be approved but ill check to see what dr included afterall? If he added prior another year or left it as is.. Ill look n post later.. Good luck to all

I also had to show that my BMI was over 35 in 2013 and 2014.