hurley911 59 Posted January 25, 2013 Due to them not responding on your file or some how messing up you process of approval? Bcbs of alabama... ? High level manager taking to the board to request waiving as they didnt communicate or call me when it was declined for 6 month diet not being within the last year.... If I would of know declined in Sept, I could of started over the diet and been nearly done(by march) supervisor agreed and submitted file when he found out they hadn't told me.... U think I should be hopeful? Anyone had it waived ? Through your ins? Or bcbs?? Thanks and fingers crossed!!!!!! Share this post Link to post Share on other sites
JPSnAZ 33 Posted January 25, 2013 Yikes!! Theres no tellin! You know how insurance companies are... but since you're working with a high level manager and they are discussing your case, I would imagine you have a pretty good chance. If not, thats messed up because you could be super close to having your surgery already. Most insurances allow the diet up to two years previously so you shoudlnt have to start all over. Share this post Link to post Share on other sites
TheGamer 406 Posted January 25, 2013 I did not have to have the six month diet. My insurance company (UMR) gave conflicting information on if it was needed or not, so my bariatric center just went ahead and submitted my paperwork for approval to see what would happen. After a month of processing, they came back with approval, no diet needed. I should note that I had a very high starting BMI, weighing about 380 at the beginning of the approval process. Share this post Link to post Share on other sites
Rena's got this 274 Posted April 17, 2013 Due to them not responding on your file or some how messing up you process of approval? Bcbs of alabama... ? High level manager taking to the board to request waiving as they didnt communicate or call me when it was declined for 6 month diet not being within the last year.... If I would of know declined in Sept, I could of started over the diet and been nearly done(by march) supervisor agreed and submitted file when he found out they hadn't told me.... U think I should be hopeful? Anyone had it waived ? Through your ins? Or bcbs?? Thanks and fingers crossed!!!!!! Did you ever find out anything? Share this post Link to post Share on other sites
OnlyDownFromHere 6 Posted April 18, 2013 I have BCBS plan and I don't need the pre op diet at all. I'm not even a special case. My BMI is 43. I asked the surgeon and he said that they only require pre op diet for gastric banders. Sleeve and bypass people don't have to do it, although they need to do nutritional counseling which I am finishing up now. Sent from my DROID RAZR using VST Share this post Link to post Share on other sites
Rena's got this 274 Posted April 18, 2013 I have BCBS plan and I don't need the pre op diet at all. I'm not even a special case. My BMI is 43. I asked the surgeon and he said that they only require pre op diet for gastric banders. Sleeve and bypass people don't have to do it, although they need to do nutritional counseling which I am finishing up now. Sent from my DROID RAZR using VST Are you talking about BCBS of ALABAMA? If so...this gives me hope. Share this post Link to post Share on other sites
OnlyDownFromHere 6 Posted April 18, 2013 No, I'm afraid not. I'm in NY. But it's still BCBS. I don't know how much they differ vastly between states. Now, this was a NEW policy change. I looked into WLS 2 years ago and BCBS had everyone doing pre op diet. You had to lose x% amount of weight in order to get approval. Now they only require that for banders. Share this post Link to post Share on other sites
LovetoDeath 93 Posted April 18, 2013 I have BCBS in virginia and I did not need to do any type of pre-op diet. I guess every state and every company is different. Share this post Link to post Share on other sites
Alamoloser 70 Posted April 18, 2013 I have BCBS-TX and at first I was told about the 6 month diet. I get a call about about 2 or 3 weeks later saying that I didn't need 6 month diet but still had to do the pysch and other pre-surgery requirements. I had a 5 year history of over 40 BMI so I think that played a key part in it also. Share this post Link to post Share on other sites
Rena's got this 274 Posted April 18, 2013 I'm working on the pre-surgery requirements, but from what I understand, Alabama still requires the 6 month physician attended weight loss requirement. I really hope that changes, but in the meantime I've gotta get it started. I just finished a sleep study, and I have pretty severe sleep apnea, but I don't think that will change the requirement for the 6 month diet. Share this post Link to post Share on other sites
beba238 123 Posted April 18, 2013 I still had to do mine. I tried several times to contact my insurance to see if I canb skip that part but they werent trying to hear that Share this post Link to post Share on other sites
dltrautman1 27 Posted April 18, 2013 Good luck.. I was lucky - I had Aetna. I just had to have a two year history of weight and had to do 3 months of nutrition classes. Let us know what happens? I think your case may be different since they did not notify you. Share this post Link to post Share on other sites