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

Recommended Posts

Fed BCBS here. In the process told 3 nut visits...not 90 days.I will be done with those first week of sept. i have my PMD letter of medical necessity, had my psych visit. The psych visit, nut visits and the letter from my primary MD cover all the other required info. Thats all that they are requiring. The surgeon requires an ekg, labs and upper GI endoscopy. All done.

Share this post


Link to post
Share on other sites

Fed BCBS here. In the process told 3 nut visits...not 90 days.I will be done with those first week of sept. i have my PMD letter of medical necessity, had my psych visit. The psych visit, nut visits and the letter from my primary MD cover all the other required info. Thats all that they are requiring. The surgeon requires an ekg, labs and upper GI endoscopy. All done.

It is interesting, they told me to follow the benefits guide to a T. In the guide it does not mention the PMD letter...and it does say 3 months of nutritional or excuse me. It says at least three months prior to surgery date. I guess it can be interpreted many different ways. When I call they are not that helpful and tell me to just follow the benefits guide on fep.org.....It is kinda irritating that they are not more helpful.

Share this post


Link to post
Share on other sites

BCBS of NC only required 2 consecutive years documented weight. It could be from your PCP, or any other documented visit to any doctor or even the ER.

Share this post


Link to post
Share on other sites

It is interesting' date=' they told me to follow the benefits guide to a T. In the guide it does not mention the PMD letter...and it does say 3 months of nutritional or excuse me. It says at least three months prior to surgery date. I guess it can be interpreted many different ways. When I call they are not that helpful and tell me to just follow the benefits guide on fep.org.....It is kinda irritating that they are not more helpful.[/quote']

My patient advocate is the one handling all of it. She does it all the time. Asked her specifically, 3 months or 3 visits she was adamant 3 visits I even called fepblue and she told me the 3 things I mentioned. Maybe. Because my BMI is less than 40 with a comorbidity is why i need the letter from my doc.

Share this post


Link to post
Share on other sites

Yeah, I am overseas so even though the surgeon has worked with Fed patients before I am trying to make sure I dot my I's and cross my T's. I am going to call them for a 3rd time tomorrow...and see what I get. I have a year worth of medically supervised weight lose program reporting. I have had my first psych visit. I am finishing the surgeon's requirments tomorrow. Even though I don't need preapproval. I think I will send it in prior. I just got get my two year weight....which I am trying to get from GYN in the states.

Share this post


Link to post
Share on other sites

BCBS of NC only required 2 consecutive years documented weight. It could be from your PCP, or any other documented visit to any doctor or even the ER.

You're right. I mistyped.

Share this post


Link to post
Share on other sites

I just emailed BCBS overseas assistance center. Maybe I will have better luck getting questions answered.

Share this post


Link to post
Share on other sites

@SleevenChica...yes it my dog...he is no longer a puppy (will be 2 in December)...100lbs..what I need to lose ;-».

I found them very helpful when I would call fepblue. But, sometimes you get different info when you call again. My dr office has a coordinator that handles all of the insurance things. Sometimes, I think the delay in approval is that there are people in front of you that the dr office is helping. My dr office seems very busy but was always on top of everything.

I'm sure once you meet the basics it will go very quickly.

Let us know how it goes!!

Share this post


Link to post
Share on other sites

Yeah, I think being overseas most of it I have to deal with. As I was digging around on their website I noticed they have an overseas assistance center that I can email. I think that may be the way to go, so it is not I said they said. Thanks so much.

I love Labs and Goldens. I have to say it is probably the number one dog here in Colombia. My husband is so not a dog person, but I want one some kinda bad. My mom has a labrodoodle and I just heart him to pieces!

Share this post


Link to post
Share on other sites

As long as you had a bmi of 59 you didn't have to wait and you where automatically approved. At least on my bcbs plan. And if your bmi was less you had to go through 6 months of doctor dieting.

Share this post


Link to post
Share on other sites

I was told that if you apply to BCBS of Kansas that you will be denied because they don't cover any WLS and that after that, any kind of medical issue that you bill them for, like lab ect. that they will try to relate it to your wls and won't cover it either.

Share this post


Link to post
Share on other sites

Great news! I now have a coordinator that assists with procedures being done overseas. I feel so relieved. They have already sent me the initial form to get the ball rolling. I was feeling overwhelmed that I would have to do this on my own. So they issued me a case number and got all the information for the hospital here and for the surgeon.

The form is basic. Just ask if I had previous WLS and what programs I have tried. It asks if I have premorbidites....the doc will sign it and then I will send it back.

YEAH!!!

Share this post


Link to post
Share on other sites

Great news! I now have a coordinator that assists with procdures being done overseas. I feel so relieved. They have already sent me the initial form to get the ball rolling. I was feeling overwhelmed that I would have to do this on my own. So they issued me a case number and got all the information for the hospital here and for the surgeon.

The form is basic. Just ask if I had previous WLS and what programs I have tried. It asks if I have premorbidites....the doc will sign it and then I will send it back.

YEAH!!!

So happy for you!

Share this post


Link to post
Share on other sites

So happy for you!

Thank you! It is such a relief.

Share this post


Link to post
Share on other sites

This is my very first time to post..today I finally got my approval from bcbstx..its been a 6 month process..sent in the pre approval papers Tuesday and got the approval this morning(Monday). Got my surgery date for next Friday.. Tomorrow I start my liquid diet.< img src="https://s.bariatricpal.com/uploads/emoticons/default_smile.png" alt=":)" srcset="https://s.bariatricpal.com/uploads/emoticons/smile@2x.png 2x" width="20" height="20" /> bcbs was very helpful and I am super excited..

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

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 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

    ×