Few Questions on required testing and insurance

[cmathews77 10]

Ok...I have BCBS of Alabama. I am 4 months into my 6 months supervised diet. I am scheduling all of the testing that has to be done and I have some questions. First of all, I saw my bariatric surgeon a couple of months ago and my insurance claim for that appointment got denied b/c the insurance hasn't approved me for the surgery yet. My question is...do I have to pay out of pocket for all of these tests (psych eval, nutritional eval, labs, etc.) since I haven't been approved by BCBS yet? I called BCBS and that can't say for sure b/c they don't know how these places will code the tests. Anyone with the same experience?

[kari61 128]

That doesn't make any sense. You have to see the surgeon first so they can submit a request for the surgery, so they definitely should have paid for that office visit, I would fight that. I had to pay out of pocket for the psych eval but my nutritionist is included with my Dr visits. You may have to wait to get approved before you do any labs or other tests though or they may not pay for that. But definitely fight the doctor visit.

[notmeanymore 629]

I have BCBS (basic federal) of Illinois and I didnt have to pay out of pocket for ANY appointments. Only co-pays thru the whole process. I would fight that for sure.

[Rena's got this 274]

No, I haven't had the same experience....yet. I'm just getting started, but I have BCBS of Alabama through my university, and am worried about what they will cover. My first appointment with my surgeon is in 2 weeks I haven't started the 6 month supervised diet yet. Did you have to find your own supervised diet program or did your surgeon recommend one?

[heavendly06 72]

No' date=' I haven't had the same experience....yet. I'm just getting started, but I have BCBS of Alabama through my university, and am worried about what they will cover. My first appointment with my surgeon is in 2 weeks I haven't started the 6 month supervised diet yet. Did you have to find your own supervised diet program or did your surgeon recommend one?[/quote']

I have BCBS MS and I'm a State Employee. I had to pay out of pocket for my consultation with the physician, as well as weight management appointments. The physician's office did submit the claims do they can count toward my deductible. I have to meet my $1,000.00 deductible before BCBS will start contributing their 80%. I hope this helps.