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BCBSIL and nutritionist not covered

I'm so frustrated. My bp is boiling. I took the big step to decide to get lap band. Met with baratrics coordinator. I have all those tons of test appointments all scheduled as of today. My bcbs IL even covers baratric surgery. No issue there. All my tests are covered. All good. All in network.

Now I was told if the hospital- where the dietician is- bills insurance as outpatient hospital for my required 6 visits- it will NOT be covered by insurance. These visits are required by the baratric program not bcbs. I have been on phone back and forth trying to find out how they bill and not getting much help. No one knows. Finally had bcbs put me on hold and they called the hospital billing dept to see and they told her they do bill it as outpatient hospital!! So I would have to pay around $3-$4k to just have these dietician appts before I even have the surgery?! Dietician said they bill per 15 minutes and 1st appt is about $350 and they go up substantially from then on!!!! How can they not cover this if they cover the surgery?!!! I can't afford that before having the surgery!! My deductible is $1,000 and out of pocket is $4,0000! And it will start over next year which will prob be when I can have it!!!!

So I'll try contacting the coordinator one more time to see if that's really the deal. If so I guess I'm not doing this. I was all ready and worked hard getting appointments. So frustrating. It doesn't make any sense.

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Which plan do you have? What surgeon are you using? The reason I ask is because I was told the same thing and ended up going to a differ physician and finding out my insurance did cover it. If the dietician isn't in network that is the reason why.

  • Author

Bcbs PPO IL. it has nothing to do with who the dietician is. If they bill it as outpatient hospital - since there are located in hospital where bariatric program is- it is not covered. My insurance called the hospital billing department to ask how they bill it. I'd have to go to one that is not in a hospital that had their own office. There isn't one located within 15 miles of where I live. There was 1 nutritionist in network an hour away! The coordinator at hospital says she knows nothing about billing and doesn't deal with that?!! I would think they would have someone to help you with the insurance issues!!

I decided to go to the other hospital in my area that has baratric program. They do not require I see a dietician for 6 visits over 3 months. They have a dietician and other people on their team that I would see in the office and in group settings. When I see them in office it's charged as an office visit. They have an exercise person, dietician, coordinator, and an insurance specialist all in the office along with dr and nurses to help you with everything. I asked them if I get billed specifically for dietician visits and they said no. Everyone runs their program different I was told. I go to other hospital October 14 to meet actual dr doing surgery. I wouldn't even meet the dr at the original hospital I started with until all tests and appointments were met!

  • 2 weeks later...

Do you live in Chicago??? I do and my surgical center has a dietitian in house! Let me know so I can give you more info!!

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