Anthem blue cross

[halalo 13]

Any body has Anthem blue cross ppo CA and got approved recently? Could anybody avoid the 6 months diet with a NUT as a requirement for VSG?

[erykha 0]

Is that a requirement for you? I also have anthem blue cross ppo ca thru my husbands employer. But my only requirements are a nut evaluation, psych evaluation and actually i think that's it. I had already been approved once but the hospital i had to use for the surgeon i had was 3 hours away. So i ended up switching.

[halalo 13]

Oh congratulations. When did u get approved?

First they told me I need 3 nutritional visits and 2 days ago my dr's assistant told me that my insurance may ask for 6 months. I'm confused.

[erykha 0]

I was approved for October 20th but had no way of getting there. You should call anthem and double check. I was told during my first surgeon visit that ppos generally dont require alot of things. The first time around i really didnt even have any verified proof i had tried losing weight before since my original dr had moved out of state.

[thisfathasgot2go 235]

My daughter is going through the process. She is going with Dr. Feiz and was given a surgery date of November 18. She just met with her PCP today and has blood work tomorrow. She has had phone appointments with a psychologist and dietician. She has to get an EGD on November 16. I am not sure about Anthem's response for approval, but I think they are submitting this week after the blood work is processed, but Dr. Feiz seems to think the six months not apply in CA. My daughter has a BMI of 41.

Edited October 28, 2015 by thisfathasgot2go

[halalo 13]

Thanks guys it seems that the insurance has changed something or the dr assistant got confused because I was told before that I don't need 6 months of diet.

[thisfathasgot2go 235]

Follow up: My daughter is having her sleeve surgery today. She did not have to do any pre-diet counseling. She started the process around October 25 or so and got approval this week.

[halalo 13]

Congratulations I hope everything will be good after. My papers were submitted last Monday and I'm waiting for my approval

Keep us updated????

Edited November 18, 2015 by halalo

[whitty13094 3]

I have it, had to do 6 months with nutritionist. And then was approved within a week.

[bigbit 99]

@@halalo - I have Anthem BC as well. Their rules changed as of January, 2015, now requiring the 6 months doctor-monitored weight loss program as a prerequisite.

I was lucky in that I had coincidentally followed such a program in 2014, and they accepted it.

My surgeon's office says that some Anthem case reviewers are sticklers for patients fulfilling this requirement; others are letting it slide.

I had my surgery on 11/3/15.