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Anyone with bc/bs of al PEEHIP?

I work for the board of education and have bc/bc of al peehip. How hard is it to get approved? Does it take a long time to get approval? I,m just starting out and talking to the ins. company is like talking to a tree. They never answer a question fully. I really don't know what to expect. Any info would be great. Thanks!!:lol:

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When I called BC/BS of Alabama this is what they told me:

Requirement:

Medical Records from Primary Physician -

3 - yrs record showing weight and height

Medical Supervised Diet

1 - attempt

6 - month consecutive months (Medical Supervised Diet)

Need statement from primary physician stating that patient has struggled with weight for last 3 yrs and physician thinks this procedure would be a good tool in helping patient control weight and health.

I was band Oct 30, 2007.

  • Author
When I called BC/BS of Alabama this is what they told me:

Requirement:

Medical Records from Primary Physician -

3 - yrs record showing weight and height

Medical Supervised Diet

1 - attempt

6 - month consecutive months (Medical Supervised Diet)

Need statement from primary physician stating that patient has struggled with weight for last 3 yrs and physician thinks this procedure would be a good tool in helping patient control weight and health.

I was band Oct 30, 2007.

Thanks Lottie. I hope my weight loss history will be enough so I don't have to do a 6 mo diet. Did it take you a while to get approve by ins?

  • Author
Thanks Lottie. I hope my weight loss history will be enough so I don't have to do a 6 mo diet. Did it take you a while to get approve by ins?

Did your 6 mo. have to be in the year before you sumitted to ins. or could it be anytime during the last 3 years?

Hi I am a California State Retiree. When I started checking into the insurance part of it I thought I would not get pre-approved. I do have BC/BS. My plan pays 80%. Which is Pers choice. Which is Public Employees Retirement System I went around and around with the insurance company. I just got what my insurance paid. I owe $8000.00 for the surgeon, surgeon assistant, and hospital stay. I owe $190.00 for the Anthiestolotgist. So my total is $8190.00. Which I am going to do through the hospital. Also I just want to let everyone that the St. Alphonsus Hospital it Boise is one of the best hospitals that I have been in. Also the staff was very superb. The hospital from the outside you would think it is a Hotel Hilton, or Marriotts.

Edited by SHARONCRIST1955

  • 2 months later...

I am going through the process of having the lap band approved. I am using DR. Schmitt in B'ham. I am actually hoping to get my paperwork sent off by next week

I did the 6 mos. diet WORD of ADVICE: Don't miss a month or appt. My last appt. was scheduled for May 28th but we had to reschedule. The 1st available was June the 3rd I believe. I thought that would be oK. Low and behold the surgeon's office called and said that I would need to go again in June. :) I did -2 days ago. I also called bc and they said a letter from the dr. explaining that he had to reschedule would do. I did both-the extra appointment and the note from my dr.

I am also using photos to document weight history because I do not have the doctor documented weights (did not go to dr. in past 4 yrs).

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