Anthem Blue Cross Requiring 3 Months of Nutritionist's Evaluation

[Kennedy310 33]

Feeling pretty bummed this morning. My doctor's office informed me that Anthem Blue Cross will not make their decision on my surgery until I have 3 complete months of evaluations from a nutritionist. I know it's only a setback and it definitely could be worse but I'm still very annoyed since I had to wait till less than a week before the planned surgery to find it out.

Has anyone had a similar experience? Is it worth calling the insurance company to see if they will waive this requirement?

[DUBrookie03 142]

Be glad that's all they want. I had to do 6 months of dietician/dr supervised diet before they would approve me. You should do it, it helps prepare you for life after surgery, and it makes surgery healthier if you drop some excess weight first.

Good luck!

[Kennedy310 33]

Thanks. I probably wouldn't be as disappointed as I am if I had known sooner. But with less than a week to go before the planned surgery, I was in the headspace of being ready to do it.

But you're absolutely right... it could be worse & there is a benefit to working with the nutritionist. My trip to the gym this morning was not in vain. Thanks for the support! I appreciate it.

[mokee 588]

I had bcbs also ans had to do the 90 days. It did not help me because I kept thinking this is my last meal. I was warned by the dr the last month that i had to lose at least 2 to 4 lbs or he would not do the surgery. Well I did and now I am 5 weeks post op and down 33 lbs. I had Medicare also and just got a statement that Medicare paid most of the hospital bill but bcbs paid 2000 of the hospital, was worth the time.

[IsB 209]

I had a 6 month requirement. It was not fun but it did keep me focused on the goal.

[ArcusX 216]

It's pretty standard. Shame on your doctor's office for not knowing. I'd consider another surgeon. IMO, there should be no oversights this basic.

[vols fan 60]

Feeling pretty bummed this morning. My doctor's office informed me that Anthem Blue Cross will not make their decision on my surgery until I have 3 complete months of evaluations from a nutritionist. I know it's only a setback and it definitely could be worse but I'm still very annoyed since I had to wait till less than a week before the planned surgery to find it out.

Has anyone had a similar experience? Is it worth calling the insurance company to see if they will waive this requirement?

I have blue cross federal and had to have 3 month visit with primary care physician and one visit to diatician and one visit to psych and two years documented height and weight and I was approved today!

[Kennedy310 33]

I have blue cross federal and had to have 3 month visit with primary care physician and one visit to diatician and one visit to psych and two years documented height and weight and I was approved today!

Congratulations! That's great news & it's inspiring for me to hear that there's a light at the end of the tunnel.

[st2011 29]

I have Anthem BCBS of CA but I didn't have to do any supervised diet. Hmmm I hope something hasn't change since my original approval. I pushed my surgery back to March 9.

[No game 14,437]

I have anthem blue cross in California I didn't have to wait at all. my first doctors appointment/ consultation was in mid September we submitted the paperwork after 1 NUT appt. and 1 psych appt. and had surgery on 11-13-12.

O_o

[st2011 29]

I have anthem blue cross in California I didn't have to wait at all. my first doctors appointment/ consultation was in mid September we submitted the paperwork after 1 NUT appt. and 1 psych appt. and had surgery on 11-13-12.

O_o

If you don't mind me asking, what did this surgery cost you as far as everything other than the surgeon fees?

[Kennedy310 33]

I have Anthem BCBS of CA but I didn't have to do any supervised diet. Hmmm I hope something hasn't change since my original approval. I pushed my surgery back to March 9.

I'm not sure. Perhaps this is a new requirement for 2013. It might also be related to the fact that I haven't been on any formal diet plan in over 12 months. I have been following my own diet and exercise regimen after years of yo-yo dieting. I would just check to make sure, but I imagine if you already had approval it, they would still honor that. But definitely worth confirming with BCBS.

[No game 14,437]

If you don't mind me asking' date=' what did this surgery cost you as far as everything other than the surgeon fees?[/quote']

Well that's a hard one... We had a high deductible $2500. So that was almost met before starting this we had to pay the hospital 650. The dietician charged 200. The therapist around 100. All and all not bad! Because we saw the final cost it was $135.000.

My dr was Marc Zare he charged 500. Program fee and 900. For surgery..

[st2011 29]

Well that's a hard one... We had a high deductible 2500. So that was almost met before starting this we had to pay the hospital 650. The dietician charged 200. The therapist around 100. All and all not bad! Because we saw the final cost it was 135.000.

My dr was Marc Zare he charged 500. Program fee and 900. For surgery..

Yikes! I forgot about the deductible with the new year starting. That's ok though, it will be worth it. Thanks for the info.

[No game 14,437]

There is another thread here about blue cross that a woman just posted and it makes sense that they give different contracts with different employers.. My husband works for California emergency physician. C.E.P . And works in the ER at El Camino hospital. So I think it might have been easier covered by our plan