MK1986 78 Posted July 17, 2012 Good Morning! I am new to BCBS process of approval. Please share your approval stories and.how long it took? Did you have to do 6 months diet? Share this post Link to post Share on other sites
bdiddy13 32 Posted July 19, 2012 Hey.. I live in Buffalo.. And l have bcbs as well.. Yes, you need a 6 month, "medically supervised" weight loss program... This can NOT be done by the bariatric surgeons office... So your best bet is to join weight watchers for six months, during that period, visit with your primary Dr 3 times, where he/she "councels" you on weight loss.. Be sure your Dr writes this info in the Dr notes, and you get a copy of it to submit to your ins... Oh, by the way, you must FAIL at weight watchers.. If you lose too much, they will assume u dont need surgery.. Because of bcbs, my process took a year, but l finally had my surgery this past tuesday... Share this post Link to post Share on other sites
bigsleeve56 266 Posted July 19, 2012 Talk to your ins. company everyone has a diffrent approval process. I had to be accepeted to the program and then was told what hoops to jump do not assume anything and get it in writing. My bmi of 56 and several other problems has kept me from having to wate. 1 MK1986 reacted to this Share this post Link to post Share on other sites
jb14075 10 Posted July 22, 2012 My doctor referred me to Dr Posner (Buff General) without doing any programs. Dr Posner's office put me on phase 1 of the South Beach diet & once I lost 10% of my excess body weight they were able to get me approved. My first visit was late May 2011 & I was sleeved on August 23, 2011. Never had to go to weight watchers or anything like that. Share this post Link to post Share on other sites
SuiteV 15 Posted July 22, 2012 Good Morning! I am new to BCBS process of approval. Please share your approval stories and.how long it took? Did you have to do 6 months diet? Good Morning! I am new to BCBS process of approval. Please share your approval stories and.how long it took? Did you have to do 6 months diet? I have BCBS (Federal) of Georgia and I have to do a 3 month medically supervised diet. I am not sure if it is different because I am federal or because mine is through the state of Georgia. Share this post Link to post Share on other sites
tybeeanna 14 Posted July 22, 2012 Hi I have BCBS of Iowa I had to do a 6 mo Dr supervised diet, Every month I saw her for" weight management" Not office visit, or follow up!! I had to make sure that was the code they used. She filled out paper work that I got from the center where i am having the surgery. I started Jan 11 last visit was July 12.I took all six mo paper work to the center on the 12 & received the ok letter in the mail on the 19 that fast. Now I am scared to death lol. But IL bcbs just removed the 6 month requirement. Share this post Link to post Share on other sites
MK1986 78 Posted July 23, 2012 Hi I have BCBS of Iowa I had to do a 6 mo Dr supervised diet' date=' Every month I saw her for" weight management" Not office visit, or follow up!! I had to make sure that was the code they used. She filled out paper work that I got from the center where i am having the surgery. I started Jan 11 last visit was July 12.I took all six mo paper work to the center on the 12 & received the ok letter in the mail on the 19 that fast. Now I am scared to death lol. But IL bcbs just removed the 6 month requirement.[/quote'] Ok..i wonder if bcbs of wny will do the same. I just wanna fast forward 6 months! Share this post Link to post Share on other sites
tybeeanna 14 Posted July 23, 2012 Not sure, all them ask what the rules are, & that 6 mo will go be so fast. best wishes. Share this post Link to post Share on other sites
ediebumpkin 9 Posted July 24, 2012 I have BCBS of WNY and am scheduled for surgery on Aug 24th at Buffalo General. I started my process by seeing a Dr. (P.A) at a satellite office in Mayville in Feb. I was told to follow the South Beach Diet and to write down everything I ate. I saw the PA once again in March and then I didn't see anyone until I saw the Surgeon on July 11th. I asked the surgeon if he thought that would fufill the ins. companies 6 mos. diet stipulation and he said that there would be no problem because of the "paper trail" I had recorded while following the South Beach Diet. Hope that helps. Share this post Link to post Share on other sites
MK1986 78 Posted July 24, 2012 Thanks Edi. I just off the phone with insurance and was told that I had to do 6 months with the PCP and also psyc eval and nutrition visit. I guess it varies. Share this post Link to post Share on other sites
giggles012980 12 Posted July 24, 2012 I am also from WNY not sure what doc you are using but I also have BCBS & went thru synergy bariatrics. I only had to write my previous weight loss attempts & get letter of medical necessity from my primary, then I did psych eval & some classes @ the doc's office. Maybe depends on your plan with BCBS good luck! Share this post Link to post Share on other sites
MK1986 78 Posted July 24, 2012 Im in Louisiana but my insurance is BCBS of WNY. I guess it really.does depend on the plan I have. Share this post Link to post Share on other sites
MK1986 78 Posted July 25, 2012 I have BCBS of WNY and am scheduled for surgery on Aug 24th at Buffalo General. I started my process by seeing a Dr. (P.A) at a satellite office in Mayville in Feb. I was told to follow the South Beach Diet and to write down everything I ate. I saw the PA once again in March and then I didn't see anyone until I saw the Surgeon on July 11th. I asked the surgeon if he thought that would fufill the ins. companies 6 mos. diet stipulation and he said that there would be no problem because of the "paper trail" I had recorded while following the South Beach Diet. Hope that helps. Do you know if you will have a deductible with bcbs of wny if so how much? Share this post Link to post Share on other sites