Anyone With Bcbs Of Alabama?

cmathews77 · November 18, 2012

Just curious on some of the things you had to go through for approval.

hurley911 · November 19, 2012

I have been dealing with bcbs of Alabama and the approval process they said I was missing thi has such as the three year history(2 out of the 3 years they had) so I had that faxed to them and then they needed my chart notes from the dr that was a supervised diet for 6 months to meet that requirement which finally was scanned in... My coordinator sent to them but they wanted it directly from the DR... They finally received and scanned it in last Monday the 13th now I just waiting...and waiting.... 40+ bmi for 3 + years and slight sleep apnea with family history of diabetes...I did my 6 but actually 7 months of HCG dr supervised diet...hope to get approved and a surgery date before the end of the year... I know they usually take 1-2 weeks at this time of the year with so many people trying to get approved so trying to be patient... What's your story!!?

cmathews77 · November 19, 2012

I'm at the VERY beginning of my process. I still have so many questions and don't even know where to begin...do I start by call the surgeon's office or my PCP? My insurance requires 40 + BMI with no problems or 35 + with problems. You've got to show documentation of this for at least 3 years. Also, got to have supervised diet for 6 months. The concerns I have are this...1. My BMI is over 40 but has flucuated for the past three years. I had a baby 2 1/2 years ago and was very sick so I lost a lot of weight during pregnancy and after I had her I was down to around 200 but quickly gained it back. So, I'm not sure what they will say about that. 2. I have been to numerous drs. about my weight over the years, but don't have 6 consectutive months to show. Like I said, I don't even know where to start! Any suggestions?

hurley911 · November 20, 2012

As far as your bmi- the way I understand it is if it does fluctuate its ok- your wanting to

Prove that you can't keep the weight off. That's the way my nutritionist explained it to me. The big one is having the 6 month physician supervised diet. They will not budge on that one. For that I would contact your PCP about that and get that started. I actually have 8 months of a physician supervised diet and they still asked for more information and chart notes on it- they are pretty strict about that one. But the way the nutritionist explained it the bmi can fluctuate.

hurley911 · November 20, 2012

Also- I would research surgeons and get your consultation done as the surgeons office is the one that actually submits to your insurance for approval. Plus they usually have a insurance coordinator that will help with all of that stuff.

cmathews77 · November 20, 2012

Thanks so much for your help! I called my PCP yesterday and have an appt. with him next Wed. to get the 6 mth diet started. I hope he doesn't give me any problems about it. Thanks and good luck!