Approvals with BCBS Federal

[SleeveandRNYchica 1,155]

I have Basic.

[elrios1 47]

So my breakdown with my surgical group goes like this:

$730 paid in two payments for all wellness consults, pre bad post op nutrition appointments,patient material and weight loss nutrition class

$150 for 3 month nutrition program

$300 for Bariatric Advantage liquid diet

$153 for Bypass Vitamin kit

This is my upfront out of pocket cost totally $1333.

Additionally, since I already met with their Behavioral Specialist I went with her for the psychological exam for an added costs of $225. I decided to go with her because when I called another psych he told me my insurance would cover the appointment, but not the his time to right the report for additional $175. So with copay I would have been close to $225 anyway!

I also had to have Barium Swallow copay $40 (I think) and EDG copay $100.

I will have my surgery at a Center of Excellence so I think the copay is $150. The office told me lost surgery I will get a letter of necessity in which I can then submit to my insurance for possible reimbursement. Since these are considered wellness providers procedure codes are nonexistent.

So when it's said and done it will be close to $2k. Not to mention this is my second rodeo.

Wow I haven't paid anything out of pocket yet and I completed the nutritionist classes abd the psyc. They sent my info off to insurance on monday so I am waiting now. Was only told I would have to pay $100 per day for hospital. Idk weather to expect a bill for the rest or if it was included in the "program"

[elrios1 47]

My Vitamins and shakes I am buying over the counter so I don't count that, but havent paid any co pays yet

[SleeveandRNYchica 1,155]

So my breakdown with my surgical group goes like this:

$730 paid in two payments for all wellness consults, pre bad post op nutrition appointments,patient material and weight loss nutrition class

$150 for 3 month nutrition program

$300 for Bariatric Advantage liquid diet

$153 for Bypass Vitamin kit

This is my upfront out of pocket cost totally $1333.

Additionally, since I already met with their Behavioral Specialist I went with her for the psychological exam for an added costs of $225. I decided to go with her because when I called another psych he told me my insurance would cover the appointment, but not the his time to right the report for additional $175. So with copay I would have been close to $225 anyway!

I also had to have Barium Swallow copay $40 (I think) and EDG copay $100.

I will have my surgery at a Center of Excellence so I think the copay is $150. The office told me lost surgery I will get a letter of necessity in which I can then submit to my insurance for possible reimbursement. Since these are considered wellness providers procedure codes are nonexistent.

So when it's said and done it will be close to $2k. Not to mention this is my second rodeo.

Wow I haven't paid anything out of pocket yet and I completed the nutritionist classes abd the psyc. They sent my info off to insurance on monday so I am waiting now. Was only told I would have to pay $100 per day for hospital. Idk weather to expect a bill for the rest or if it was included in the "program"

Are you basic or standard because I swear the copayment is more than $100. Are you having surgery at a Center of Excellence?

[elrios1 47]

Basic, yes was supposed to be $150 or $175 but they said only $100 because they are part of some program. But like I said no co pays so far

[elrios1 47]

Wonder why you had to pay for wellness consult. Did you not go through a bariatric center? Do they not have their own nutritionist?

[PlBren 21]

I also have basic. Here are my charges to date -

Four visits to the surgeon (my "weight loss consultations for 3 months) - $35 copay each so $140 total

Nutritionist visits (2) and Exercise Consults (2) - $300

Psychologist evaluation - $25 copay (but I am choosing to go to her for consults through the surgery so I'm paying an extra $200 not required.

EDG copay $100

Abdominal sonogram and chest Xray (done on the same visit) $35 copay

So - total to date - without any approval as of yet - $700. But, I had my sleep study and blood work already done previously.

Expected additional cost -

EKG - $25 copay

More blood work - $25 copay

Hospital/Surgical copay - $350

So $400 more....Assuming I get approved!

Patty - 2 days post insurance submittal...waiting for approval or denial...

[SleeveandRNYchica 1,155]

Again, I think our programs vary per surgeon. That's great if the pay provide your NUT Appts are no cost!

Wonder why you had to pay for wellness consult. Did you not go through a bariatric center? Do they not have their own nutritionist?

They do but it's not free lol!

[elrios1 47]

Unless I am going to be billed later idk. I also haven't met with the surgeon yet, I dont see him unless I am approved and ready to have surgery. =/

[PlBren 21]

Are any of you BC/BS Federal employee folks in the DC area like me?

[SleeveandRNYchica 1,155]

I also have basic. Here are my charges to date -

Four visits to the surgeon (my "weight loss consultations for 3 months) - $35 copay each so $140 total

Nutritionist visits (2) and Exercise Consults (2) - $300

Psychologist evaluation - $25 copay (but I am choosing to go to her for consults through the surgery so I'm paying an extra $200 not required.

EDG copay $100

Abdominal sonogram and chest Xray (done on the same visit) $35 copay

So - total to date - without any approval as of yet - $700. But, I had my sleep study and blood work already done previously.

Expected additional cost -

EKG - $25 copay

More blood work - $25 copay

Hospital/Surgical copay - $350

So $400 more....Assuming I get approved!

Patty - 2 days post insurance submittal...waiting for approval or denial...

Where are you having surgery?

Are any of you BC/BS Federal employee folks in the DC area like me?

I am....

[PlBren 21]

Where are you having surgery?

Are any of you BC/BS Federal employee folks in the DC area like me?

I am....

SleevenChica -

Your profile says CO (I assumed Colorado). I am having the procedure done in Rockville. How about you?

[SleeveandRNYchica 1,155]

Where are you having surgery?

Are any of you BC/BS Federal employee folks in the DC area like me?

I am....

SleevenChica -

Your profile says CO (I assumed Colorado). I am having the procedure done in Rockville. How about you?

No, I am in VA. I lived in Colombia when I had my sleeve. It's really CB. I just don't think back then CB was an option

[SleeveandRNYchica 1,155]

I am not sure why my location is not updated. It is in my profile.

[scoutmom 63]

@@PlBren

Hi there - I am on my husband's BCBS Fed and was sleeved May 26th at Bluepoint (inova Fairfax). I live in Alexandria, but was willing to drive as I really liked the surgeon and practice.

I also have a friend who submitted today on BCBS Fed - hoping she gets a fast answer! I was lucky and knew in 3 days.