BCBS requirements

[mommabear2311 31]

Hello,

Does anyone know if BCBS requires 6 months or 180 days of monitoring before surgery?

TIA

~Sandy~

[Charlotte Krenzer 0]

I varies from state to state, I believe. However, in Wyoming they require six months of monitored dieting. Additionally you must prove that you have been obese (with documentation for 5 years).

[Monet08 63]

For NC it's a little different if they do it as inpatient you have the 6 visits with NUT and need an authorization. Outpatient you don't have to do all the visits nor will a authorization be needed

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[PNWsleever 44]

Bcbs of illinois does not require any dieting. Best of luck!

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[KristenLe 5,980]

@@mommabear2311 It not only depends on the State but often on your particular BCBS plan and patient circumstances. You need to find out the requirements specific to you and have the surgeon's office confirm them (I was given wrong information by BCBS Rep).

[Monet08 63]

You should also be able to go to your insurance plan main page and under medical policy of you don't know the code type in weight loss and it will show you all requirements . I hope this helps

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Edited August 25, 2016 by Monet08

[Nana1222 159]

I went to look at my main page and med pol and it shows no requirements I'm going to call BC/bs and ask where they see the six month requirement to visit pcp or nutrionist

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[Nana1222 159]

I actually found the right page and it doesn't give me access darn it lol I'll call and ask them to send me them. I'm so impatient

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[amyflores 23]

Bcbs in Kentucky requires 6 months

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[RNMomof4 86]

6 months medically supervised diet for Anthem BCBS of va

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[maredarlin 12]

I'm pretty sure it differs between the plans within BCBS. I have BCBS in New Jersey and it took me a little more than three months to complete all the pre-cert requirements. The Doctor told me it could take anywhere from 5 - 15 business days at that point for Horizon to make a decision, but it only took them five days. So It moved along pretty fast for me. It's just a matter of getting all of your pre-cert work done, showing your committed to the process, and doing what needs to be done.

Good luck!

[bia1nca1 38]

BCBS MN required 6 months of supervised diet by PC doctor or dietician. I just got my approval today. It took 8 business days for approval. They told me it could take up to 10 business days for approval. Now I'm just waiting on a surgery date.

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[busybeebug 415]

Highmark BCBS in PA requires 6 months

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[pansy27 23]

My bcbs in NC did not require any supervised diet.. It did require I meet with nurtrionist but no required number of appts.

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[mommabear2311 31]

Thanks so much everyone! Sept 7 will make my 6 months. I'm looking forward to surgery!

~Sandy~