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Anyone with Blue Shield of CA

Hi there,

I was wondering if there is anyone who has been approved and had surgery with Blue Shield of CA insurance. I have undergone testing and still have just a few more things to do before they submit me. I have my psych eval on Friday, which the bariatric coordinator stated that this is all that they are asking for a copy of. She said after she gets that in, she will submit it to Blue Shield of CA.

I was just wondering if anyone else had it and could tell me a round about time it took to hear something back after needed paperwork was submitted.

Thank you! :biggrin:

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Hi there,

I was wondering if there is anyone who has been approved and had surgery with Blue Shield of CA insurance. I have undergone testing and still have just a few more things to do before they submit me. I have my psych eval on Friday, which the bariatric coordinator stated that this is all that they are asking for a copy of. She said after she gets that in, she will submit it to Blue Shield of CA.

I was just wondering if anyone else had it and could tell me a round about time it took to hear something back after needed paperwork was submitted.

Thank you! :cursing:

Every situation is unique and much depends upon any exclusions your policy may have, so this is just my experience.

I had my orientation on 9/22/08 and, after much research into the procedure, began tackling my pre-requisites on 9/29/08. My insurance paperwork was submitted on 11/18/08 and I was approved by the morning of 11/21/08. My surgery is scheduled for 12/16/08.

I attribute much of my success with approval to the bariatric center being a Center of Excellence. They were also very well-versed in submitting for insurance and were familiar with the "i's" and "t's" that needed to be dotted and crossed.

I hope you have as quick a turnaround as I did! Good luck to you!

Yes, I have Blue Shield of California with Calpers, which is managed by Hills Physicians. After completing all the insurance requirements and Bariatric Center requirements I was approved within 24 hours. Below is a time line.

January 08 met with PC doc and started the process.

January 08 started supervised diet for 6-months.

February 08 completed and passed the pysch eval

August 08 insurance approved me to meet with the bariatric surgeon.

Sept 08 completed bariatric center orientation, nutrition class, and pre-op class.

October 08 met with bariatric surgeon.

October 08 completed upper GI and H-pylori test

October 15 bariatric surgeon submitts all documents to Blue Shield.

October 16 Blue Shield approves surgery

Ocober 26 complete all surgery pre-op tests

November 11 surgery was done and band went on.

Good luck.

Yes, I have Blue Shield of California with Calpers, which is managed by Hills Physicians. After completing all the insurance requirements and Bariatric Center requirements I was approved within 24 hours. Below is a time line.

January 08 met with PC doc and started the process.

January 08 started supervised diet for 6-months.

February 08 completed and passed the pysch eval

August 08 insurance approved me to meet with the bariatric surgeon.

Sept 08 completed bariatric center orientation, nutrition class, and pre-op class.

October 08 met with bariatric surgeon.

October 08 completed upper GI and H-pylori test

October 15 bariatric surgeon submitts all documents to Blue Shield.

October 16 Blue Shield approves surgery

Ocober 26 complete all surgery pre-op tests

November 11 surgery was done and band went on.

Good luck.

Hi TQUAD64...I've been thinking about you and wondering how it's going with you? How's band-life treating you?

I am doing great. I am down 30 pounds and two pant sizes. I am back into my old clothes from a year ago and hope to move past 220 by the end of December. I am on the mushie stage. I have great restriction as the doctor put 3ccs in my band during the surgery.

I left a post for you on your LBT wall.

  • Author

Awesome, it sounds like the answer comes in fairly quickly. Hopefully, it won't take that long once submitted. I am anxious for Friday to get here and see how long afterwards it takes them to get it submitted.

Thank you all for taking the time to answer my question! Best of luck to all of you with your bands. :cursing:

  • 2 weeks later...

HI PSJ71!

I'm in the process of submitting all my tests and evals and wanted to see what you had to turn in. I haven't done the six month diet yet but I have been vaguely monitored by my PCP for years.

Things I've completed so far:

seminar- done

lab work- done

respiratory eval- done

cardio eval- done

psych eval- done

consult w/ dr.- done

nutritionist- pending

Is there anything else? I have a PPO and called the insurance. They didn't have a list of things that need to be completed :rolleyes2:

thanks for any insight.

-m

Edited by Mariel83
error

HI PSJ71!

I'm in the process of submitting all my tests and evals and wanted to see what you had to turn in. I haven't done the six month diet yet but I have been vaguely monitored by my PCP for years.

Things I've completed so far:

seminar- done

lab work- done

respiratory eval- done

cardio eval- done

psych eval- done

consult w/ dr.- done

nutritionist- pending

Is there anything else? I have a PPO and called the insurance. They didn't have a list of things that need to be completed :rolleyes2:

thanks for any insight.

-m

I had to do an upper GI and a Hpylori test.

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