Jump to content
×
Are you looking for the BariatricPal Store? Go now!

It's In Review?



Recommended Posts

I have BCBS Fed and my paperwork was sent to them on Nov. 26 I called them yesterday and they told me that it was in review. What does that really mean? I'm new at all of this so I have no clue.

Share this post


Link to post
Share on other sites

It's pretty simple, they're just reviewing what you or your surgeon submitted to see if you qualify. I too have BCBS Federal insurance and it took about a week to get an answer. I'm not sure what you submitted but with my information submitted it included my complete blood work, Xrays, psych eval, nutrition counseling, seminar information, surgeon and family doctor recommendation, pulmanory clearance, and my Upper GI clearance. A lot of the things I listed were not required through my insurance but through my actual surgeon. All that my insurance required is that my BMI be over 40 and that I have a psych eval and a surgeon recommendation.

After my first approval, last minute I changed my surgeon along with the hospital. I've gone through the approval procedure twice.

Each plan is different so I'm not sure which will apply to you. The entire process takes about 2 months, from you initial visit with your surgeon to your actual surgery date. But then again every surgeon is different and may require less or more time.

Just be patient and things will work out. This is a serious surgery and every precaution should be taken. Good luck and I hope this was helpful!:thumbup:

Share this post


Link to post
Share on other sites

thanks that was helpful. I see u are from Ga. too so were going through the same BCBS. The only thing my Surgen did was typed up a letter stating my BMI and my health history thats about it. They really didnt do anything, they just asked a few questions and typed the letter.

Share this post


Link to post
Share on other sites

Hi Jasmin..l too have Federal B/C and B/s.. my paperwork sat on someones desk for over a month, until l called daily to see when it was going to move..after calling so many times l actually ran into someone on the other end of the phone who had bypass surgery several years ago..she understood how important this was to me...l would recommend calling daily...lf not you may end up like me, waiting and waiting for someone to do their job....Good luck to you and hope it all goes well...l couldn't be happier..

Share this post


Link to post
Share on other sites

I just can't believe BCBS is giving you the run around that much. It's obviously not that unbelievable since they are insurance but I had no problems what so ever. Not sure why but maybe going to your surgeons just wasn't enough for them. My doctor didn't leave any question unanswered. I find it kind of ackward that your doctor doesn't want you to get any type of clearance from other specialist. But they're all different and they all take their own level of precaution. I really hope everything follows through for you.

Share this post


Link to post
Share on other sites

Hi Winthropgrad08, l think its bec it FEDERAL b/c b/s....they are buggers...after all the time l waited then they denied me, to approve me the next day....l was told by my Dr that the Federal B/c was the worst to get an approval from...

Share this post


Link to post
Share on other sites

I have Federal BCBS and had no problems. In fact, they were very helpful with anything I needed when I called. My doctor told me that they were one of the easier ones. What he also said was that BCBS for STATE employees was horrible and that they do not cover most bariatic procedures.

Share this post


Link to post
Share on other sites

a friend of mine has bc/bs of ga the federal kind and it was approved.she stays here in albany.she looks really good.she just had to pay a small portion.

Share this post


Link to post
Share on other sites

I too have BCBS Federal and I was approved in less than 48 hours. My surgeon's office had their own list that I had to follow even though it was not required for the insurance approval.

I had to get clearance from my primary, my pulmonary, and I had to see a cardiac doctor too. Then I had to have a chest x-ray, blood work, upper gi, and ultrasound of my gall bladder. I also did a sleep study and it found I had moderate sleep apnea. Because of that I also needed clearance from the sleep doctor.

I never thought I would be approved so quick based on what others said here and in support. I hope that you receive an answer very quick. Stay on top of them and do not give up.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×