BCBS Fed apprival

[spealex 13]

Just got notification from my surgeon’s office manager advising me that I had been approved for revision from Band to bypass. Request was submitted Monday, with approval received today, Wednesday.

My requirements were 3 nutritionist visits, psych, and 2 years medical history.

I was very surprised at the speed in which my approval was given.

[Creekimp13 5,841]

BCBS has been really awesome with my surgery. I really expected to have to fight, appeal, etc. But nope...they were on board from day one. They did require 6 months of dietitian appts, etc... But when it came time to approve the actual date...they were right on it and sent a hard copy letter within 10 days. Billing has gone smoothly, too. Am owing less out of pocket than expected so far....though I expect a few bills might still trickle in.

[spealex 13]

That is good to hear. That remains a question to me, one I hope to get clarified during pre op. I have seen wide ranging totals, from $250 to as high as $3000 for out of pocket costs. I didn’t think it could range that much, hopefully I can get that answers soon.

[Shelbel 7]

Bcbs federal denied my claim. We’re appealing right now. I have a BMI of 35 and have comorbidities but they said they weren’t good enough. I think something didn’t get submitted correctly. We’ll see how it goes.

[Creekimp13 5,841]

What are your comorbidities? Diabetes+hypertension usually will work. You need TWO if your BMI is under 40. Some conditions are not as convincing to insurance companies as others.

Your BMI being 35 could disqualify you, particularly if it hasn't been 35 or above consistently for the last two years of your medical history. If you've had periods of dipping into a BMI of 34...or your comorbidities are less serious....you might be out of luck until you've been overweight longer.

But definitely give it a shot...can't hurt.

Edited January 17, 2018 by Creekimp13