Does anyone have BCBS? How was the overall process and how long did it take for approval?

Edited December 12, 20205 yr by Hopefulin2021

I have bcbsil and it was easy took a week

Thank you so much! I have one more nutritional class then my team will submit everything I am hoping to have the surgery within 8 weeks.

Congratulations I had the sleeve done 11/30 and no pain I hope all goes well for you

Thank you and good luck with your continued journey

I have bcbs. It was very quick. Meet with Dr. on 10.27.20. Original surgery scheduled for 11.30.20.

Wow it only took a month? I had to have test, bloodwork, a psych eval, and 6 nutritional classes. I finished everything and I have one more class left on Monday. I am hoping it won’t take forever and a day to get approved I am so ready for this. Did you get the surgery?

I had gone to different doctors because I wanted to make sure I was knowledgeable about what I was considering. All of them required a psych evaluation. One of them required that you meet with a doctor every month for six months. One of the doctor’s during the interest Zoom, did not discuss anything as it related to the surgery. I went in for an in person consultation with that doctor, and again spoke nothing about the surgery. I was already seeing a nutritionist prior to make a decision about have surgery.
Lastly, I had to move the surgery date from 11.30.20 to 12.21.20.

I think everything depends on who you select to be your Doctor. They all have different requirements. Everyone I say had very different requirements.

BCBS here also. My requirements were only it must be a center of excellence, once there a psych eval, nutrition appt, and then a consult. My submittal to insurance to approval back was like 6 days total. Total from start of everything to my surgery date...I started 11/6 with this surgeon and my surgery is 12/22!

Good luck!!!

I have BCBS Tennessee. I think there may be some differences from state to state. Mine required 3 months of medically supervised weight loss, a psychological evaluation, and a letter from my PCP (my surgeon had some additional requirements, but I think that was all that was required for insurance approval). The surgeon's office is very familiar with insurance requirements and took care of most of it. I was initially denied because the insurance company required some specific wording in the letter from my PCP. The surgeon's office sent my PCP an example letter (basically fill-in-the-blanks) and once my PCP sent the letter with the correct wording, I was approved within a few days.

BCBS Illinois. 3 or 4 days after submitting.

1 hour ago, RTL1234 said:

BCBS here also. My requirements were only it must be a center of excellence, once there a psych eval, nutrition appt, and then a consult. My submittal to insurance to approval back was like 6 days total. Total from start of everything to my surgery date...I started 11/6 with this surgeon and my surgery is 12/22!

Good luck!!!

Wow that’s amazing! Please keep me updated with your surgery!!!

1 hour ago, RTL1234 said:

BCBS here also. My requirements were only it must be a center of excellence, once there a psych eval, nutrition appt, and then a consult. My submittal to insurance to approval back was like 6 days total. Total from start of everything to my surgery date...I started 11/6 with this surgeon and my surgery is 12/22!

Good luck!!!

That’s amazing you’re almost there! Good luck and please let me know how it went!!

1 hour ago, BigSue said:

I have BCBS Tennessee. I think there may be some differences from state to state. Mine required 3 months of medically supervised weight loss, a psychological evaluation, and a letter from my PCP (my surgeon had some additional requirements, but I think that was all that was required for insurance approval). The surgeon's office is very familiar with insurance requirements and took care of most of it. I was initially denied because the insurance company required some specific wording in the letter from my PCP. The surgeon's office sent my PCP an example letter (basically fill-in-the-blanks) and once my PCP sent the letter with the correct wording, I was approved within a few days.

Yes I’m in New Jersey and the surgeon is very well-versed in what is required. I am hoping all goes well and I get to update this forum with a surgery date. Congrats to you!

49 minutes ago, bufbills said:

BCBS Illinois. 3 or 4 days after submitting.

Wow awesome! This is giving me hope that it won’t take forever for an approval

We have Anthem/BCBS of Indiana and like others I had to have nutritional counseling, meet with behavior therapist, release from my family physician, records of previous attempts at losing weight as well as medical records from various records shared with the bariatric surgeon. My original request was denied 16 days after submitting the "packet", but once resubmitted it was pproved within 24 hours.

47 minutes ago, Hopefulin2021 said:

Wow awesome! This is giving me hope that it won’t take forever for an approval

The worst of it is getting through all of the surgeons pre op stuff. Important stuff though. If your BMI is over 40 or 35 with weight related issues, you should have no problem.