lisamarie8308

Thank you so much! I am finally feeling confident that I will get approved as I have completed everything else. After reading your post, I made an Excel spreadsheet with each month from 1/16 through 4/17, listed my weight, BMI, and what diet I attempted. Most of the months were myfitnesspal, and a few were weight watchers or low carb and Contrave. Do you think that will be acceptable? Thank you SO MUCH for all of your help! <3

Hey @bnicolexo: I came across this post doing a search for BCBS NC. Were you approved for the surgery? My last appt before submitting to them is 4/19, and I am worried about getting denied due to their 12 month recent change. I am hoping you got good news!

Hi everyone! I am in the beginning stages of the process towards the gastric sleeve surgery, and my seminar is on Thursday. I live in FL, but have BCBS NC through my husband's work. I just got off the phone with their customer service and am very confused, so I am hoping you all can help me! I have been doing reading online about their requirements for coverage, and I know that BCBS NC just changed their policy to reflect " documentation of 12 consecutive months of active engagement in weight related treatment, as described above. Judgement regarding the scope, depth, and adequacy of pre-surgical treatment during the 12 months prior to surgery is at the discretion of the multidisciplinary weight loss surgery team, and BCBSNC does not specify the content of the treatment." The lady that I spoke to on the phone said the only requirement was this documentation of 12 months, and when I asked her about the psychological evaluation or the meeting with the nutritionist, she said that those are not showing as required. However, when I check their website, this document states that they ARE required. https://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/surgery_for_morbid_obesity.pdf Now here are my questions: I have been seeing my PCP off and on since 2013 (did not go when I with between jobs and did not have insurance). I went back to her in June or July of 2016, and have bee going consistently since then. She has documents of my weight from 2013 on, has been working with my on my weight since then, and put in the referral for me to my bariatric surgeon. She is 100% in support of me having the surgery done as soon as possible. I told the rep from BCBS that I don't see my PCP every month, but she didn't know if that would be a problem or not. Thoughts? Is the approval process for BCBS NC difficult? And how long does it typically take? And last question: Is the surgical center helpful in this process? This insurance stuff is super overwhelming!! Thanks so much! Lisa