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

Insurance approval

samniccc

Recommended Posts

samniccc    12

samniccc
Posted

Hey guys! First time posting here but I'm just kind of curious, I have BCBS Michigan, I was wondering if anyone else has the same insurance and how long it took for your approval? Even if you don't have the same insurance I'd still love to hear! I just got done with all insurance requirements, everything has been sent and now it's up to them! The nerves have officially set it. Thanks for reading

chryss and Kierajay reacted to this

Share this post

Link to post
Share on other sites

Kierajay    43

Kierajay
Posted

I have BCBS (NORTH CAROLINA) and I had Aetna last year so when I was going through the program with atena I only had to 6 months. However Aetna had dropped out of the affordable Health care & BCBSNC was the only one available but to make a long story short BCBSNC required 12 months but the provider I was going through said that if I could get info on everything I did before like info about what doctors I talked to about my weight & what they prescribed like toprimate & phetermine and things like that I can get approved before and would not have to do another 7 months (which I cried & prayed that I wouldn't have too!!) so one day I went driving and to my primary care doctor and talked to him about a letter of recommendation with all my medical records and sent it back to the office all I can say is I love them(BCBSNC) because they approved me right when I was leaving the doctor from my endoscopy I just had the bypass 3 weeks ago. I believe if you have information before you started the program it will count as if you did 12 months.

Good LUCK! [emoji1474] it's going to happen before you know it [emoji847]

Share this post

Link to post
Share on other sites

samniccc    12

samniccc
Posted

I have BLBC and I see my surgeon on Wednesday this week and then they are submitting my claim. I will let you know!




Thanks so much! Best of luck.


Share this post

Link to post
Share on other sites

samniccc    12

samniccc
Posted

I have BCBS (NORTH CAROLINA) and I had Aetna last year so when I was going through the program with atena I only had to 6 months. However Aetna had dropped out of the affordable Health care & BCBSNC was the only one available but to make a long story short BCBSNC required 12 months but the provider I was going through said that if I could get info on everything I did before like info about what doctors I talked to about my weight & what they prescribed like toprimate & phetermine and things like that I can get approved before and would not have to do another 7 months (which I cried & prayed that I wouldn't have too!!) so one day I went driving and to my primary care doctor and talked to him about a letter of recommendation with all my medical records and sent it back to the office all I can say is I love them(BCBSNC) because they approved me right when I was leaving the doctor from my endoscopy I just had the bypass 3 weeks ago. I believe if you have information before you started the program it will count as if you did 12 months.
Good LUCK! [emoji1474] it's going to happen before you know it [emoji847]

Thanks for the info! Congrats on the surgery & best of luck to you [emoji173]


Kierajay reacted to this

Share this post

Link to post
Share on other sites

briski    11

briski
Posted

I have BCBS of MI too. My consultation with the surgeon is May 9th so I can't actually answer your question, but I read somewhere that they don't actually formally approve the surgery. They just tell the surgeon's office what the requirements are and it's up to them to make sure you meet them. I'm not for sure about this though. Where are you at in the process?



Share this post

Link to post
Share on other sites

samniccc    12

samniccc
Posted

I have BCBS of MI too. My consultation with the surgeon is May 9th so I can't actually answer your question, but I read somewhere that they don't actually formally approve the surgery. They just tell the surgeon's office what the requirements are and it's up to them to make sure you meet them. I'm not for sure about this though. Where are you at in the process?





I have completed all of the requirements and everything has been sent to insurance. Just waiting on the approval and then I'll see my surgeon for a surgery date. The insurance coordinator told me i would have an answer in 10-14 days.


briski reacted to this

Share this post

Link to post
Share on other sites

briski    11

briski
Posted


I have completed all of the requirements and everything has been sent to insurance. Just waiting on the approval and then I'll see my surgeon for a surgery date. The insurance coordinator told me i would have an answer in 10-14 days.




Any word yet?

Sent from my Z981 using BariatricPal mobile app

Share this post

Link to post
Share on other sites

chryss    61

chryss
Posted

Hey there! My hospital officially submitted on Wednesday at 2:00 pm. My insurance called me on Friday at noon to tell me I was approved!!! So less than 2 days!


Share this post

Link to post
Share on other sites

Kierajay    43

Kierajay
Posted

Hey there! My hospital officially submitted on Wednesday at 2:00 pm. My insurance called me on Friday at noon to tell me I was approved!!! So less than 2 days!




YEAAAAHHHH[emoji1494][emoji1494][emoji1494][emoji1494][emoji1494][emoji1494][emoji133][emoji133][emoji133][emoji133] congrats [emoji322][emoji322]What are you having the bypass or sleeve?


chryss reacted to this

Share this post

Link to post
Share on other sites

chryss    61

chryss
Posted

I'm going for bypass! I was originally going to get the sleeve but found out that my severe GERD would be unbearable with the sleeve. I'm very excited! What did you get Keirajay? How are you doing?


Share this post

Link to post
Share on other sites

samniccc    12

samniccc
Posted

Do you know anything yet??? I am so praying you do[emoji177][emoji844]

Still no word [emoji25] waiting by my phone every day! Thanks so much for the support [emoji173]

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 Tell Your Weight Loss Surgery Story

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.

  • 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!

    ×