I'm curious if anyone recently got surgery with the insurance Blue Cross Blue Shield of Illinois? I'm aware a couple of years ago they required a six month medical assisted diet. But, now they no longer require the diet. What do you'll think about this? Does anyone have BCBSIL, how did the process go for you?

http://www.bcbsil.com/provider/standards/medical_policy.html

Here is the link for the current policy with criteria for bariatric surgery. Good luck!

I have BCBSIL and it took 8 weeks from first visit with the Surgeon to Surgery.

http://www.bariatricpal.com/topic/344568-approval-healthcare-exchange-plan-bcbsil/

http://www.bcbsil.com/provider/standards/medical_policy.html

Here is the link for the current policy with criteria for bariatric surgery. Good luck!

Yep.. that's the information my insurance provider gave me. Thanks;)

I have BCBSIL and it took 8 weeks from first visit with the Surgeon to Surgery.

http://www.bariatricpal.com/topic/344568-approval-healthcare-exchange-plan-bcbsil/

Hey I appreciate the information:)

I have BCBS Illinois-PPO. I saw the surgeon Sept. 17th; paperwork filed Nov. 5th, My paperwork was misfiled with the incorrect group per BCBS. I called and requested that my pre-authorization be escalated for due to their error and possible postponement of my procedure. They returned my call within 10 minutes with approval this AM! Just awaiting scheduler. Just make certain that the office provided you with a fax confirmation, date, and time. That is how my 'misfiled' paperwork was located

I have BCBS Illinois-PPO. I saw the surgeon Sept. 17th; paperwork filed Nov. 5th, My paperwork was misfiled with the incorrect group per BCBS. I called and requested that my pre-authorization be escalated for due to their error and possible postponement of my procedure. They returned my call within 10 minutes with approval this AM! Just awaiting scheduler. Just make certain that the office provided you with a fax confirmation, date, and time. That is how my 'misfiled' paperwork was located

Yayyy.. Congratulations on your approval and thank you for the info

Sent from my SM-N900V using Tapatalk

Thank you! Good luck to you as well. Please reach out if you have any questions about navigating with BCBS-Illinois.

I have BCBSIL and I saw my surgeon last week. They need me to do an at home sleep study since I haven't been diagnosed with sleep apnea but I do have it.

Will I have to wait too for 6 months of nutrition before I can get approval?

BCBS IL has three requirements: the BMI, nutrition/fitness assessment, and psyche eval. My surgeon's office filed once those three were met and I still had other studies pending specific to the surgeon (bone density scan, stress test, etc.) I was approved before the others were completed. BCBS IL does not have a 6 month nutrition or medically supervised requirement. Hope that helps.

Thank you. It does. I hope to hear from them soon.

Thank you so much!!!

I have BCBSIL and I saw my surgeon last week. They need me to do an at home sleep study since I haven't been diagnosed with sleep apnea but I do have it.

Will I have to wait too for 6 months of nutrition before I can get approval?

BCBSIL no longer requires the six month diet, or is that something else your talking about?

BCBS IL P. P. O. Doesn't require a 6 month diet.

BCBS IL H. M. O. Does requires a 3 month monitored diet.

There are different requirements depending on the network.

Additionally, if your BCBS IL P.P.O. is employer covered it is possible that your employer had elected to NOT cover bariatric surgery so please do your homework.

Edited December 15, 201510 yr by HopeandAgony

Thank you all for the input. Called my insurance today. Requirements: BMI, nutrition counseling (no specific duration of time), and psych eval.

Copay of $250 and if I pre-cert my hospital stay (calling them to let know when my surgery is) I don't have to pay the $300 copay for hospital.

Hoping my surgeon clears me soon so I can get this done. And for a sum of $250 plus any other copays for exams etc, oh I would have done this a long time ago!

BCBS IL P. P. O. Doesn't require a 6 month diet.

BCBS IL H. M. O. Does requires a 3 month monitored diet.

There are different requirements depending on the network.

Additionally, if your BCBS IL P.P.O. is employer covered it is possible that your employer had elected to NOT cover bariatric surgery so please do your homework.

I have done my homework, however, it's always more to learn which is why I asked her the question and posted this topic in the first place. And I already know the employer doesn't have to cover bariatric surgery ... so Please don't be rude we are all up here to learn and help others. I don't need anyone telling me what I need to do homework in. Maybe you should read more carefully, and go back and read other post before making these type comments. Thanks in advance!

Edited December 15, 201510 yr by LadyWarren

Thank you all for the input. Called my insurance today. Requirements: BMI, nutrition counseling (no specific duration of time), and psych eval.

Copay of $250 and if I pre-cert my hospital stay (calling them to let know when my surgery is) I don't have to pay the $300 copay for hospital.

Hoping my surgeon clears me soon so I can get this done. And for a sum of $250 plus any other copays for exams etc, oh I would have done this a long time ago!

Yayyy... congratulations! This is what I was asking you, and what I thought was confirmed:)

Sent from my SM-N900V using Tapatalk

BCBS IL P. P. O. Doesn't require a 6 month diet.

BCBS IL H. M. O. Does requires a 3 month monitored diet.

There are different requirements depending on the network.

Additionally, if your BCBS IL P.P.O. is employer covered it is possible that your employer had elected to NOT cover bariatric surgery so please do your homework.

I have done my homework, however, it's always more to learn which is why I asked her the question and posted this topic in the first place. And I already know the employer has to cover bariatric surgery ... so Please don't be rude we are all up here to learn and help others. I don't need anyone telling me what I need to do homework in. Maybe you should read more carefully, and go back and read other post before making these type comments. Thanks in advance!

Seriously? Rude? Yikes... That is a first for sure. Employers don't have to cover Bariatric surgery but it sounds like you've got it under control. Good luck in your journey.