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

    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 1 reply
      1. stevieoriole

        Am feeling this right now. My surgery date is 4/1. Sign the consent tomorrow. I feel like I overloaded myself with too much info, too many opinions. Got to the point where I was wondering if I should do this. Then I thought of my reasons for taking this step and that settled my nerves. Still get moments of doubt but am striving forward. Am just going to follow my book from the surgeon. Joined this because I was told by my dietician that I should do this for support

    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

  • 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

    ×