Bcbs Of Ga And Approval Questions

[grammyto2 8]

Would anyone know if a bmi of 38.74, 240lbs, high cholesterol, asthma, GERD's, sleep apnea, 48"waist, and late 40's female would be enough to qualify for wls (sleeve) through bcbs of ga? I do know my insurance covers wls but I am not 40 plus bmi nor do I have diabetes, hbp, although my mother and both of her parents have both. Just not sure my issues are qualifying comorbidities?! Thanks

[IMSKINNY 160]

Would anyone know if a bmi of 38.74' date=' 240lbs, high cholesterol, asthma, GERD's, sleep apnea, 48"waist, and late 40's female would be enough to qualify for wls (sleeve) through bcbs of ga? I do know my insurance covers wls but I am not 40 plus bmi nor do I have diabetes, hbp, although my mother and both of her parents have both. Just not sure my issues are qualifying comorbidities?! Thanks[/quote']

I'm not sure about your insurer, but GERD and sleep apnea usually qualify as comorbidities associated with weight.

[lovealways 22]

I would call and find out the exact requirements. Usually obstructive sleep apnea is recognized as a co-morb.

[grammyto2 8]

Thanks for responding! I have talked with bcbs ga and they even sent me policy in regards to surgery, but it only read bmi 40 plus, or bmi 35 or greater with 2 qualifying comorbidities like diabetes, hbp, and there was one more, but I can't remember....(working).....anyhow the things I mentioned were not listed. But it said like not only....so I tried to look on internet to find qualifying cms and nothing yet for my insurance. I had hoped someone else might have dealt with this insurance for similar circumstances and might possibly be able to clue me in on requirements....but the responses were helpful just the same!!

[ebonisekim 1,713]

Maybe try going thru w your process w a surgeon it's coordinator cus he or she helps out a lot w what these insurance companies want cuz they deal w plenty if them .. My coordinator from my surgeon office is very helpful when it comes to what I need to do

[grammyto2 8]

I appreciate the advice! I've already been to seminar, and have my first appointment in 2 weeks, when do I get a cordinator? Almost all of my testing has been done through my PCP before I attended seminar, and yes they can be used at center. I'm not sure how the sequence of events occurs I k.ow I still have to do psych eval. and nutritionist, and surgeon jbut not the length of time from one to the other and where the approval/denial from insurance falls into place .... Rambling, SORRY!

[ebonisekim 1,713]

When u meet your surgeon he or she will have a coordinator ...but I can't meet my surgeon until I have my paper work .. But my coordinator gave me a package to follow what I need for my insurance company and I gave a package to my pcp but I just call her when I run into something I don't understand she is the one I deal w until then .. That person is usually nurse to the surgeon

[grammyto2 8]

Thank you this helps.....a lot! Any advice to help move things along smoothly and faster for bcbs ga would be great too.