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Showing results for 'Fed BC/BS'.
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:confused2:Hi! I got a call yesterday afternoon from the medical management lady who is on my case and she said she would be calling me by 5pmest to let me know if i have eben approved. If you could please say a little prayer for me for an approval that would me a lot to me. I don't think I have ever wanted something more than this!!! PLEASE APPROVE ME!!!! XOX Barbie
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Cigna denied my surgery....
illinoishusker replied to sfwaitinginma's topic in Insurance & Financing
Ok,I find this frustrating. I'm sure you went in there and told them you are doing the diet for the lap band and they didn't write good notes? BS! ugh. I was a pain in my dr. arse. I kept saying, um make sure you document everything discussed, like exercise, nutrition, portion size..etc. I hope they'll do it. -
Question on Precertification
Big As Life replied to stefgray's topic in PRE-Operation Weight Loss Surgery Q&A
Wow...ladies, that is great....I am so happy for all of you....I have never heard of an insurance company doing this, but sounds like that is typical for BC/BS Federal....CONGRATULATIONS TO ALL THAT ARE APPROVED....YOU ARE GETTING READY TO BE BANDED.... -
Hello everyone. I am new to all this. Just went to my 1st seminar & have my 1st Dr. Consultation May 9th. Already have an appointment with a dietician set up for May 14th to begin the 6 months for my Insurance which i already know does cover the surgery. when i called the dr.'s office they asked what insurance we had....i told them BC then they asked what company through .i told them and the reaction was Oh yeah they cover WLS ! .....i am now in the process of gathering my medical records for the past 5 years or so so i can take them in with me the 9th when i go see the dr. * SO EXCITED * Angie :biggrin:
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Did you try to appeal this? I suspect there are different levels of coverage. I have Empire Blue right now but may be switching to BC/BS of MI and would be pretty dissapointed if they didn't cover fills etc.
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Motivation....I believe we can motivate ourselves and succeed
☠carolinagirl☠ replied to victorisaac's topic in LAP-BAND Surgery Forums
the only thing i can offer (besides my unwavering support) is want power. you must want to lose weight bad enough to do it. (following your dr's instructions, eating better food and exercising). i dont believe in will power. i can will myself into just about anything but wanting something..that is different. find that want power deep inside and then just do it. no excuses. no drama. no BS. want it bad enough to do whatever it takes to get it done. and then do it. -
Hi. I thought I would share this link. My appologies if it has been posted before. Surgery for Morbid Obesity
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Anyone used BC/BS that works for General Motors? What Dr did you use, what city, state? Do you know what diagnosis code was used? thanks
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Leaking/damaged port after fill?
me54him63 replied to olwen's topic in POST-Operation Weight Loss Surgery Q&A
I just had my port revised in July. I had the band for 22 months before having a problem. My problem started with pain around and deep into my port site. I then started noticing that I was eating more. The revision went well. There was basically no pain. I was camping in a tent 3 days later. I have BC/BS for insurance and they paid for everything. I had to have an endoscopy and some fluoroscopy also. Slowly I've started to have some restriction, I've had 3 fills since being replaced. I've heard that insurances will pay for the revision much easier then replacement of the whole band. -
I'm Here At The Beach And...
Raven21 replied to shellbell125's topic in PRE-Operation Weight Loss Surgery Q&A
*!*!*!*!*!*!*! DO IT!!! *!*!*!*!*!*! (pretend this is flashing) I know exactly how you feel! My legs and arms are tan, in front. The backs are white because I'm going to lay on my stomach? Hahahahaha. I can't even go without a chair because I'd never be able to get up off the ground. Hard enough getting out of a chair. And God forbid I should forget my chair because I can't use anyone else's because I will break it! Even worse, I sweat like a PIG! How cliche', the fat girl sweats a lot. It's the little things like this. The constant, daily, BS that we have to consider before anything! Because we are fat. Let's not be fat anymore! Let's think about eating different food in place of thinking about how to be fat today. Because I spend way too much time trying to figure out how to "fit" fat into the lifestyle I want! -
Contingent Denial Pending "Peer Conference"
Violetflame replied to Violetflame's topic in Insurance & Financing
OK, for anyone following this, my pathetic saga continues. ANTHEM BCBS, (the bs part fits) put my surgeon on hold for fifteen minutes today during their "peer conference"!!! I am livid! irate! My Dr is proceding with a level one appeal while the conference is rescheduled......Has this happened to anyone else? I seem to attract difficult scenarios. -
. I have Aetna Health Maintenance Organization..Im currently 270 with a BMI of 41....I know i qualify with a BMI >40..I'm hearing that Aetna requires a 2 year weight history. Will they deny bc I havent been 270 for the last 2 years. My weight fluctated from 225 to 270... -
Kelli, I have Federal BC/BS of Kansas City and what Tiff wrote was all that was required by me. When I went for my psych eval. the doc had previously sent me some paperwork and there were some questions that asked me about what kind of diets I had been on ,how long, and how much I had lost. I'm five weeks post op, so that must have done the trick. Good luck!!! Deb
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Two days of clears is AWFUL
AmandaWho replied to Walter.Sobchak's topic in Gastric Sleeve Surgery Forums
I LOVED broth when I went through that. It was a godsend. Now I can't even stomach the smell of it. I still make myself a cup once in a while bc I loved it so much and one sip makes me want to die. It's amazing how good it is before and how it is the actual devil after! Keep it up! We got your back!! -
So I'm thinking about giving up on my insurance fight and just switching to self-pay. I had a slipped band over a year ago. It took 6 months to get the insurance company (Fed BCBS) to finally agree to remove the band but they denied a revision to VSG stating it wasn't medically necessary because my BMI was under 35. I submitted an appeal to the Federal Office of Personnel Management in October for what was supposed to be a 60 day appeal. They "lost" my case and had to start over. Then they closed it because they didn't understand I was asking for a revision and not some sort of random partial gastrectomy. They finally sent it out for review but it sounds like they didn't select a bariatric surgeon because the answer last week came back that it isn't medically necessary because my weight isn't over a 40 BMI. The told my attorney to wait for the report and then call and talk to the nurse but I haven't heard back yet. At this point it's been almost 7 months since I submitted the appeal. This has been going on for so long I'm almost back to my original weight. If I had it to do over again I'd have done a self-pay revision with Dr. Aceves right from the start. Heck, I'd be at my goal weight by now. I just don't have it in me to keep this up. I went ahead and requested a surgery date with Dr. Aceves and put first-class airline tickets on hold on my miles. I can't think what hoops the insurance company would have next. They just don't get that the standard of care for a revision doesn't require you to regain all your weight first. I could go forward with the surgery and then sue them after the fact but I'm not sure it's worth the mental energy after all this. I had some old Microsoft stock lying around and it's almost enough for the surgery. I'm thinking that I'll never miss the money and can just get on with my life. I don't want to self-pay up here because it's really expensive and they don't cover complications like Dr. Aceves does. I could be down there next weekend having this done and just moving on. Thoughts? I could use some additional input... Thanks! Britt
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I may have a good chance for a job change with a different agency and it be well worth my time to take it, so far they have gotten a reference from my supervisor so it looks good. I have e-mailed HR (VT) and trying very hard to find out if CIS carries the Fepblue with the 3 mo WLS lapband plan - no answer ---If you know anyone who works for them, If they have the BCBS fed plan and if the coverage is the same with the same WLS prerequisites, please let me know... I know it is alot to ask, but the job is falling right in the middle of when the surgery could take place. - I am stressed because I do not have a surgery date until after OCT 6 when paper works is submitted, and I really would like to know what to say, with out giving all my surgery details, should they send me a job offer. I know I am rambling, It's like too many blessing at once!
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Hi.. I will be changing to Blue Shield H MO after the new year. According to them, the way my husband's employer's contract was written, lap band surgery is covered...no restrictions! Almost too good to be true...I will be confirming next week. Anyway, since I see on these boards that BS H MO has covered others here, maybe I am not dreaming. I was wondering...since all bariatric surgeons are contracted....how do I know what doctor I will be referred to? I mean, usually on a H MO, you belong to a group and then any doctor you are referred to is in that group. However, bariatric surgeons are not in any group so how is the doctor decided on? I want to make sure I get a good, safe, and reputable one. Thanks- Jennie
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Unfortunatly, I think in NJ, most phych are going to be out of network. BC/BS and i basicly had to submit the eval as out of network
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I also have Anthem BC. I got approved very quickly, no problems. I had to do the psych exam, nutritionist, and a medical eval done by my regular doctor.
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I had my surgery on February 15th. Since then I don't feel any different. I don't feel full since started soft purée diet. I am hungry all the time. I lost my sense of smell. The only difference is I feel tired. I will confess I ate two ritz crackers the other night Bc I felt so nauseous. What am I doing wrong?! Could my pouch Be open? Is it beneficial to restart my phases again? I feel horrible for eating the crackers.
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finally decided to go for it
wendy645 replied to sdaniel75's topic in Tell Your Weight Loss Surgery Story
There are some references to bc/bs in the insurance forum, but I wanted to wish you the best of luck!!! -
So- whoever is out there is Lap-Band space, I have hit an all-time low I think! I have been banded a little over a year and have lost a little over 100 pounds! However, my personal life- well no longer exists. I was engaged- and I am in the process of moving out because, well that didnt turn out as planned. I am getting the attention I used to when I was thinner- however not from the people I want to. I feel like I cant please myself bc I have been on a very slow moving decline in weight over the past few months. I feel like I am so close to being done that now its not going to happen and with everything else personally- I am starting to feel hopeless- like no one else understands me! Any ideas?
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So- whoever is out there is Lap-Band space, I have hit an all-time low I think! I have been banded a little over a year and have lost a little over 100 pounds! However, my personal life- well no longer exists. I was engaged- and I am in the process of moving out because, well that didnt turn out as planned. I am getting the attention I used to when I was thinner- however not from the people I want to. I feel like I cant please myself bc I have been on a very slow moving decline in weight over the past few months. I feel like I am so close to being done that now its not going to happen and with everything else personally- I am starting to feel hopeless- like no one else understands me! Any ideas?
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I have Highmark BC/BS through the railroad so I'm sure it's not exactly the same, but it took them about 25 days to approve me. They told me they have 30 days to approve or deny, and they were always very helpful when I called and spoke with them. It actually took me longer to get my surgery date then for the insurance to approve, that took a little over a month before I had my surgery. Good luck, I hope it all works out.
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odd question about smoking and drinking...
CurvyCat posted a topic in PRE-Operation Weight Loss Surgery Q&A
I am neither a regular smoker or regular drinker. The two do tend to go hand in hand for me, but usually it is weeks or months between my 'party' nights out. I don't drink or smoke at all when not in these sorts of social situations, and I do neither to excess when I do go out. Once every year I go on a campout with a group of people that is pretty much a party group. I've been going to this event for over 10 years and it's my one time of year when I get to let my hair down for a few days. This year, it happens to fall over Memorial Day weekend, which is right before my 2-week pre-op diet. I am going to TRY not to drink more than a beer or two each day or smoke any cigs at all, but I know it's going to be difficult around this crowd. I'm wondering how much effect a few days of less-than-perfect behaviour with the alcohol/nicotine thing might have, or would the two weeks of following the pre-op diet to the letter be enough.... *sigh* I'm also not going to go off my BC pills until 2 weeks pre-op (as the idea of dealing with feminine hygiene while camping is not a good one), and I hope that 2 weeks will be good on that too. Argh, I hate second-guessing all this. :thumbup:
