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Approvals with BCBS Federal

rln52

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babbs2299    15

babbs2299
Posted

I'm in Hampton Roads, VA area. More specifically in Norfolk. Glad everything is going fairly smoothly for all. I agree, the insurance coordinator is what keeps the ball rolling. Mine seems to be on point and impressive. Did or is any of your docs requiring you to drop any weight or just suggesting you do?

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SleeveandRNYchica    1,155

SleeveandRNYchica
Posted

@babb2299 that's right, I lived in Norfolk for undergrad. No my dr did not have me lose weight. Actually I have gained about 7lbs.

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babbs2299    15

babbs2299
Posted

I put on 5lbs this last month and you would have thought I committed a felony! They told me I needed to lose what I had gained cause of insurance, blah blah. They were none to pleased. Personally I think it's because I just ate big Breakfast. Lol!

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RDub    57

RDub
Posted

I gained a little weight during the 3 month supervised diet too...i think it was psychological, i have been on a medically supervised diet for years and this 3 months was just for show for the insurance company. I didnt do anything different during those 3 months. I was approved in less than 2 weeks no questions asked.

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babbs2299    15

babbs2299
Posted

Well I hope it's not an issue like they made it out to be. 5lbs on me is nothing, it's a meal and some Water. I'll told them the 5lb plus some would be gone next month when I weighed in. Then they told me not to lose to much. Craziness! I'm just ready to get approved and get on that table and get this done. Excited for this new "tool".

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RNYDawn    160

RNYDawn
Posted

Im sorry if this is addressed elsewhere but would someone walk me through their steps? Did you just call the surgeon's office for a first appointment and go from there?

I have BCBS fed and I'm so thankful!

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SleeveandRNYchica    1,155

SleeveandRNYchica
Posted

@ here all the insurance guidelines. You could go ahead and consult with your PCP while starting with your surgeon your weigh history can come from any of your drs

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RNYDawn    160

RNYDawn
Posted

@ here all the insurance guidelines. You could go ahead and consult with your PCP while starting with your surgeon your weigh history can come from any of your drs

Thank you!

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fluffytofit    25

fluffytofit
Posted

Hey ladies...just wanted to post an update on where I'm at in this process.

August 14th- 1st Visit with Surgeons Office

September 20-2nd Visit with Surgeons Office, and 1st with Dietician

October 27th-3rd Visit with Surgeons Office, and 2nd with Dietician.

At my September appt, my surgeon's NP said they will submit to insurance after my next appt, which is tomorrow. I already had my psych eval, labs, EKG, and barium swallow done. My gallbladder was removed years ago, so I didn't need the ultrasound for that. I do have question though, and I've gotten varying answers. Does my first visit with the surgeon count? The bariatric coordinator said it did, but I read on here that some didn't. My best friend had hers submitted today, although she doesn't have FEP BLUE. It's getting real!!!

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SleeveandRNYchica    1,155

SleeveandRNYchica
Posted

My 90 days was from the 1st Nutrition Appt. I saw her June 3, July 10 and August. Last weigh in was Sept 3. Then I was submitted.

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fluffytofit    25

fluffytofit
Posted

Should I expect to be seen again in November? What do you think about them submitting after tomorrow? She said they submit to insurance before patients are all done with their pre-reqs all the time.

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SleeveandRNYchica    1,155

SleeveandRNYchica
Posted

My experience was I had to be finished with my requirements. Your doctors office may be different. I don't think you will have any issues!

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babbs2299    15

babbs2299
Posted

I just got insurance approval through BCBS (fed) yesterday. My surgery date is Nov. 9th. It took 2 days to approve it once everything was submitted by my surgeons office.

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SleeveandRNYchica    1,155

SleeveandRNYchica
Posted

I just got insurance approval through BCBS (fed) yesterday. My surgery date is Nov. 9th. It took 2 days to approve it once everything was submitted by my surgeons office.

Yeah!!! I am so happy for you!! Congratulations!!!!!

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • 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. 
       
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    • 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.
    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.

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