Sleeve revision with FEP Blue

[Jones218 0]

Hey all,

I have a small hernia and GERD from sleeve surgery. My insurance is FEP Blue of MD. My doctor submitted a pre cert and FEP Blue said I needed behavioral health and nutrition visits to approve even though it’s a revision due to complications. My doctor then canceled the pre authorization and Re enrolled me to start the whole program over with again. Does this seem right ? I feel like I’ve seen other people have a very seamless process when having a complication based revision. I feel like the insurance and the doctors office is not properly communicating with me or each other. Any advice ?

[catwoman7 10,859]

might be some requirement of the insurance company (?) - not sure.

[SeattleLady 277]

Hey all,

I have a small hernia and GERD from sleeve surgery. My insurance is FEP Blue of MD. My doctor submitted a pre cert and FEP Blue said I needed behavioral health and nutrition visits to approve even though it’s a revision due to complications. My doctor then canceled the pre authorization and Re enrolled me to start the whole program over with again. Does this seem right ? I feel like I’ve seen other people have a very seamless process when having a complication based revision. I feel like the insurance and the doctors office is not properly communicating with me or each other. Any advice ?

Talk with the person who works to get insurance approvals in the doctors office.

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[pintsizedmallrat 470]

I have FEP Blue and while I wasn't going for a revision, I had gone through the entire process and had an approval, and my surgery was originally scheduled for early 2020. The state I was living in cancelled all elective surgeries for several months at the beginning of the pandemic, and then we moved to another state. I had to start the entire process completely over when I contacted the original surgery center 18 months later (after having tried to start with a place in WV where the dietitian made me cry and I decided I'd rather drive 3 hours than put up with that).

I suppose the good news here is that even if you do have to start over, FEP Blue's requirements are a little less of a pain than some others; you only have to do the supervised diet for 90 days and a lot of insurance companies require six months or a year.

[Ranece 49 0]

Hello, I’m FEP BLUE Illinois and it took 7 months for my surgery to happen. I had revisional gastric bypass. Don’t give up it’s worth it