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Anthem BCBS

Tashagirlxo

By Tashagirlxo, in Insurance & Financing

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Tashagirlxo    41

Tashagirlxo
Posted

Hi guys! So I'm all done my requirements per my surgeon. I should be able to submit my information to the insurance this week. A couple things I wanted some opinions on. 1. I haven't gone to the doctor for 6 months so they could track my weight. 2. I'm not sure what state my insurance is out of?? I live in New Jersey so I'm really unsure. Any ideas?? I'm super nervous and after reading all these posts I feel like I'm going to get denied. I'm at 40 BMI, but I feel like they're going to want me to do a 6 month documented diet.

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Tashagirlxo    41

Tashagirlxo
Posted

My doctor said they would type something up showing I tried a diet for 6 months but I feel like that wouldn't be sufficient?

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blizair09    3,250

blizair09
Posted

I have BCBS Anthem. They required six monthly visits with the surgeon's nurse practitioner, 1 visit with the nutritionist, a psych evaluation, and a medical clearance from my PCP. The surgeon's staff took really detailed notes on my weight loss each month of the six months and submitted all of that documentation (it was a binder full of stuff). Nothing could be submitted until everything had been completed. lost 100 pounds during my six month pre-op program, was at exactly a 40 BMI on the day of surgery, and I was approved. It took 2 weeks from when they submitted the paperwork for BCBS to approve it.

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Tashagirlxo    41

Tashagirlxo
Posted

Wow thank you so much!

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blizair09    3,250

blizair09
Posted

Wow thank you so much!

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My pleasure. Good luck!

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teedsg    253

teedsg
Posted

@@Tashagirlxo, not sure about this one because every insurance company and policy is different. I have BCBS of Michigan and I live in Georgia. The company I work for corporate office is in Michigan. They required 6 months nutritional visits with a nutritionist, PFT, chest X-ray, EKG, Certification/Letter of Support from PCP. I'm not done with all of my requirements, I have 2 more nutritional visits to go, but I'm going to try to get my PCP to submit my info this week. My surgeon is trying to get me to get it done before the end of the year, which I agree because I would have to reach my deductible all over again if it goes into next year.

However, I read on a post on BP that mentioned that they got approved for their surgery and they were on their 4 month visit. I also read on here where someone got approved just by using Weight Watchers online. I didn't even know that counted...Hope this helps. Crossing my fingers for you...

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Tashagirlxo    41

Tashagirlxo
Posted

@@teedsg I'm going to call them this morning to see if they can tell me which state my insurance is out of and go from there! If I don't need the 6 month supervised diet, then I can submit all my paperwork to the insurance within this week or so.

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Clarevoyant    347

Clarevoyant
Posted

I have BCBS Anthem. They required six monthly visits with the surgeon's nurse practitioner, 1 visit with the nutritionist, a psych evaluation, and a medical clearance from my PCP. The surgeon's staff took really detailed notes on my weight loss each month of the six months and submitted all of that documentation (it was a binder full of stuff). Nothing could be submitted until everything had been completed. lost 100 pounds during my six month pre-op program, was at exactly a 40 BMI on the day of surgery, and I was approved. It took 2 weeks from when they submitted the paperwork for BCBS to approve it.

Exactly the same for me. Had to go monthly!

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Tashagirlxo    41

Tashagirlxo
Posted

So I got clarification this AM that my insurance is based out of Ohio. Cross your fingers for me guys! I should be going in soon to submit all my info

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teedsg    253

teedsg
Posted

@@Tashagirlxo, that's awesome! Crossing my fingers and toes.

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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