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Anyone with Blue Shield of CA



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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! :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!

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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.

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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?

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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.

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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:

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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

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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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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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