Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

PA Highmark, BCBS....advise/help!

cls5186

By cls5186, in Insurance & Financing

Recommended Posts

cls5186    23

cls5186
Posted

Hey all, it's me again...still confused and looking for help.

So i live in PA and have Highmark BCBS insurance, this was my second month of supervised weight loss/exercise PCP visit. My question to anyone who is or has had sleeve or bypass surgery with this insurance, do i need 6 consecutive monthly visits with a dietician as well? The insurance requirements is so vague and i can't get a straight answer when i call my insurance company. It's frustrating and confusing, anyone able to offer help? I had a consultation with a dietician who gave me a nutrition plan to follow, she also read the requirements and said it looked like only a consultation was enough along with 6 monthly PCP appointments.

Help!!

Share this post

Link to post
Share on other sites

vamping    183

vamping
Posted

I have a different BCBS, but if it were me, I'd give them a call or send a secure message if you have a portal and have them clarify.

Share this post

Link to post
Share on other sites

KristenLe    5,979

KristenLe
Posted

@@cls5186 I could never get an answer from BCBS of RI about the requirements. After several weeks, they told me to ask the surgeon's office. ????.

Your PCP might be able to find out specifics. Highmark does have some stuff online though. The 6 month supervised diet must be supervised and monitored by a physician but working in cooperation with dietician. My Bariatric Program has a NUT on staff so it was the surgeon who supervised it.

Share this post

Link to post
Share on other sites

cls5186    23

cls5186
Posted

Thank you ladies! I'm calling and demanding someone answer this question, it's so ridiculous. I have my first appt with my surgeon early next month, they seem familiar with all types of insurances so I'm praying they know

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

thisgirlhunts    94

thisgirlhunts
Posted

I have Highmark BCBS in PA. I met once with the surgeon (initial consultation), 6 times with my NUT (and weighed in each time to track what the insurance required me to lose), once with the exercise physiologist, and then another visit with the surgeon about 2 weeks out from my surgery.

My surgeon's office staff was very helpful in explaining all the insurance requirements during my initial visit.

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

cls5186    23

cls5186
Posted

Exercise physiologist? Hmm, my plan doesn't say anything about that. I called and got some info today, she told me 6 times with you PCP or NUT or like 3 and 3

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

thisgirlhunts    94

thisgirlhunts
Posted

I think every surgeon's practice is different. I don't believe it was an insurance requirement; just a requirement for my surgeon. But the exercise physiologist did help me with a pre-op exercise plan and I can consult with him (and the NUT) as much as needed post-op.

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

Nana1222    159

Nana1222
Posted

I called my BC/BS in Iowa and they said they can't release that info to call the surgeons office. Surgeons office said Surgeon will tell me what I have to do when I meet with her in Oct. So I'm just going to wait and get answers then.

Sent from my iPhone using the BariatricPal App

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing Insurance & Financing

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Clueless_girl

      Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 0 replies
      1. This update has no replies.
    • Mr.Kantos

      Mr.Kantos

      Just signed up. Feeling optimistic.
      · 0 replies
      1. This update has no replies.
    • Frugal

      Frugal

      Welcome to Frugal Testing, where we are committed to revolutionizing the software testing landscape with our efficient and affordable solutions. As a pioneering company in this field, we understand the challenges faced by startups, small to medium-sized businesses and any organization working without budget constraints. Our mission is to deliver top-notch testing services that ensure the highest quality of software, all while keeping your costs in check.
      Frugal Testing offers a comprehensive suite of testing services tailored to meet diverse needs. Specializing in different types of testing including functional testing, automation testing, metaverse testing and D365 testing, we cover all bases to guarantee thorough software quality assurance. Our approach is not just about identifying bugs; it's about ensuring a seamless and superior user experience.
      Innovation is at the heart of what we do. By integrating the latest tools and technologies, many of which are cutting-edge open source solutions, we stay ahead in delivering efficient and effective testing services. This approach allows us to provide exceptional quality testing without the high costs typically associated with advanced testing methodologies.
      Understanding each client's unique needs is fundamental to our service delivery. At Frugal Testing, the focus is on creating customized testing strategies that align with specific business goals and budget requirements. This client-centric approach ensures that every testing solution is not only effective but also fully aligned with the client's objectives.
      Our team is our greatest asset. Composed of skilled professionals who are experts in the latest testing techniques and technologies, they bring dedication, expertise and a commitment to excellence in every project. This expertise ensures that our client’s software not only meets but often exceeds the highest standards of quality and performance.
      Frugal Testing is more than just a service provider; we are a partner in your success. With a blend of quality, innovation and cost-effectiveness, we are here to help you navigate the complexities of software testing, ensuring your product stands out in today's competitive market. 
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×