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BC BS ALABAMA

losingtoloveme

By losingtoloveme, in Insurance & Financing

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losingtoloveme    0

losingtoloveme
Posted

Anyone who had surgery that used BC BS of ALABAMA how long after your first appointment with doctor did it take to get approval. What all type of hoops did they require you to jump through. If you didn't have to go through the 6 months that I have heard they make you go through how did you get through not doing that. Thanks

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Chelle Bean    51

Chelle Bean
Posted

Hello I have BCBS AL , Started my process May , and had to do psych eval, sleep study, weigh in monthly, give last 3 year weights, see my PCP 3 times , letter from my PCP , and meet with the NUT. They can not submit my paper work until Nov 13th so , I have to wait to hear back from them. It has been a long process but I'm beyond ready by this point! Let me know how it goes for you

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Champ715    207

Champ715
Posted (edited)

I have BCBS AL and was required to do the six month supervised diet (which is really 7 visits), meet with my PCP three times during the six month process, and have three years of weight records showing consistent BMI over 40. I did not have to do a psych evaluation or sleep study. The biggest hurdle for me was tracking down three years of weight history. I didn't have the same doctor for the last three years so I had to track down records from three different physicians. I was told I would be automatically denied if at any point in the last three years my BMI was below 40. One doctor visit last year listed my BMI has 39.3 because I got very sick and lost about 12 lbs. I had to dig up other records from last year to show a BMI over 40 so that was tricky to track down.

My first appointment was sometime in March (can't remember the exact date). My last appointment with my NUT and surgeon was 9/18. My paperwork was submitted electronically online on 9/21 and I was approved instantly. I had my surgery on 9/30.


Hello I have BCBS AL , Started my process May , and had to do psych eval, sleep study, weigh in monthly, give last 3 year weights, see my PCP 3 times , letter from my PCP , and meet with the NUT. They can not submit my paper work until Nov 13th so , I have to wait to hear back from them. It has been a long process but I'm beyond ready by this point! Let me know how it goes for you

Just curious why they can't submit your paperwork until November?

Edited: nevermind, I didn't catch the part about starting your process in May. I guess May to November is your six months.

Edited by Southern Sleever

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Chelle Bean    51

Chelle Bean
Posted

Well Nov 13th came an went and guess what I'm still waiting. The doctors office didn't send my paper work out until Nov 18th and when I called BCBS on Monday she told me that they sent everything but my sleep study! So they mailed that to them ? BCBS says they could have faxed it. I don't know what the hold up is however my insurance changes on Jan1 :( Praying for surgery before then.

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Leesa926    72

Leesa926
Posted

I'm in the same boat with Blue Cross Blue Shield of Ohio. Doctors office didn't send the facility information so I have to wait till Monday and my insurance also changes next year

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Chelle Bean    51

Chelle Bean
Posted

keep me posted Leesa926 let me know how it goes for you. Good Luck

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Chelle Bean    51

Chelle Bean
Posted

No I didnt hear anything yet either.......... Just think when we do how excited we will be! Happy Thanksgiving

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Soon2BHealthyAggie    23

Soon2BHealthyAggie
Posted

Hello I have BCBS AL , Started my process May , and had to do psych eval, sleep study, weigh in monthly, give last 3 year weights, see my PCP 3 times , letter from my PCP , and meet with the NUT. They can not submit my paper work until Nov 13th so , I have to wait to hear back from them. It has been a long process but I'm beyond ready by this point! Let me know how it goes for you

Wow, I have BCBS of AL and the only requirement is 6 month physician supervised weight management. My surgeon requires other items, but not the insurance.

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Suers1019    6

Suers1019
Posted

I am in the BCBS boat too! My insurance changes 1/1 then it won't be covered. I have jumped through all the hoops and last primary appt is Tuesday. Then off for approval! I am praying we have no problems! Hoping for 12/17

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