Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Few Questions on required testing and insurance



Recommended Posts

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?

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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.

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

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • 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

    ×