Question for those that have BCBS federal

[Brighteyes 237]

Quick question...part of my insurance requirement is three months physician supervised weight loss. Here is the question. After your third visit did your paperwork get submitted, or did you have to go in for a fourth time to count a solid three months? Maybe it's a silly question, but I am trying to get an estimate as to how quickly I could get in for surgery.

[Kaj 88]

I saw my family Dr.; told him what I wanted; he gave me a 1500 calorie exchange diet sheet (on which I promptly gained weight); went back 30 days later and checked in; went back in another 30 days and checked in, went back for a final 30 day check-up and he sent my records to my surgeon's office to submit to insurance. So -

saw Dr ------>30 days pass, saw Dr.------> 30 more days pass, saw Dr----->30 more days pass, saw Dr.; he submitted to my surgeon.

Does that help?

[Arts137 1,811]

Have BC?BS Federal. Went to orientation, saw surgeon. Got hooked into group that did all the classes, NUT, Psyc, etc. From Soup to nuts took 5 and a half months...

[Brighteyes 237]

Yup, that answers my question. Had an issue with my PCP. He told me to find another physician cause he didn't want to do the paperwork. It took me almost a month to get in with a different one. I will have to talk to my insurance rep with the surgical office to see if we can get my first visit counted. I hate the idea of being a month behind on the process.

[notmeanymore 629]

Thats how it worked for me as well. I had my initial visit then 30 days later was my 1 month visit, 30 days later 2 month visit, 30 days later 3 month visit and they informed my surgeon that I fulfilled the requirement. In total 4 visits. The visits didnt even have to be 30 days apart, just in the following month. I had a period of time between 1 of the appointments of only 2.5 weeks so that helped speed me up a little. But in the 3 months I was doing the medically supervised diet I took care of the requirements (pulmonologist, psych eval, blood work, ekg, etc.) so once the three months was up I could be submitted as soon as possible.

Ive been told and have read that BCBS Federal is your cadillac of insurances, Once submitted I was approved in about a week and a half I think. Others have been approved within a week. Scheduled for surgery the next month.

[Brighteyes 237]

Thats how it worked for me as well. I had my initial visit then 30 days later was my 1 month visit' date=' 30 days later 2 month visit, 30 days later 3 month visit and they informed my surgeon that I fulfilled the requirement. In total 4 visits. The visits didnt even have to be 30 days apart, just in the following month. I had a period of time between 1 of the appointments of only 2.5 weeks so that helped speed me up a little. But in the 3 months I was doing the medically supervised diet I took care of the requirements (pulmonologist, psych eval, blood work, ekg, etc.) so once the three months was up I could be submitted as soon as possible.

Ive been told and have read that BCBS Federal is your cadillac of insurances, Once submitted I was approved in about a week and a half I think. Others have been approved within a week. Scheduled for surgery the next month.[/quote']

Thanks. This is helpful. I am going to push the insurance company to count my appointment with my PCP last month as my first appointment. It wouldn't be such a big deal but I have a trip planned for mid Dec and I wanted to be done with my special diet. It would be a lot easier traveling if I still wasn't working through a restrictive diet. Fingers crossed I can get things worked out.

[Lulu5 24]

Thanks. This is helpful. I am going to push the insurance company to count my appointment with my PCP last month as my first appointment. It wouldn't be such a big deal but I have a trip planned for mid Dec and I wanted to be done with my special diet. It would be a lot easier traveling if I still wasn't working through a restrictive diet. Fingers crossed I can get things worked out.

Keep us posted about what the Ins Co says. I too have BCBS Fed and was told by my surgeons office that I only needed 3 visits as long as I discuss weight loss/exercise at those 3 visits. My first appt was June 25, second was July 25, and final will be Aug 26. I've met all my other requirements so as soon as I'm done with the the Aug 25 appt my surgeon's office will submit to the ins co.

[Brighteyes 237]

Keep us posted about what the Ins Co says. I too have BCBS Fed and was told by my surgeons office that I only needed 3 visits as long as I discuss weight loss/exercise at those 3 visits. My first appt was June 25' date=' second was July 25, and final will be Aug 26. I've met all my other requirements so as soon as I'm done with the the Aug 25 appt my surgeon's office will submit to the ins co.[/quote']

I will. My first appointment with my old PCP happened on 19 July. It was at that appointment he told me to find a new physician cause he thought it was 'stupid.' I went to my new PCP on 1 Aug, and already have a follow up appointment for 3 Sept. I was hoping to have surgery by early Oct, but that might be unrealistic. I will have all my other requirements done by 3 Sept. fingers crossed I get this figured out

[Lulu5 24]

That's sad he said it was stupid. I hope your new PCP is supportive. We need all the support we can get!

[Brighteyes 237]

That's sad he said it was stupid. I hope your new PCP is supportive. We need all the support we can get!

New PCP is great! I count the whole experience as a blessing. It's good I know now that my internist physician wasn't comfortable talking about weight loss. Now I have someone who will be supportive and is willing to look at my whole medical history.

[becslivinlife 10]

I am going to a Bariatric Center and they take care of everything. I first met with the nutritionist and surgeon the beginning of June. I had an appointment scheduled for an annual physical with my pcp in July, so the nutritionist told me to make sure she documents discussion of weight/diet so that it would count for one month. So maybe if your doctor documented a discussion of the surgery and your weight then it might work. I have my third nutritional appointment scheduled for next week. However, they already submitted to insurance because when the insurance person at the center called to verify the requirements they basically told her all I needed was they psych eval and primary care letter. This is not what it says in the handbook, so we shall see. I did have years and years of WW records though. I haven't heard anything back yet and they submitted at the end of July. If they deny I will proceed with next weeks nutritional appointment and they will submit again. Before they called insurance, they said they would submit immediately after the third appointment. I would say, it doesn't hurt to try and submit with the June appointment.

[Brighteyes 237]

So just a quick follow up to this. My current physician is willing to take my initial visit with my old PCP and count it as month one of the three month supervised weight loss. I will finish all my pre-surgery requirements on 3 Sept. I was advised that 1 Sept I should start my two week pre-op diet. I am on a bit of a time crunch, so I need to move forward with surgery quickly. The hospital is working with me. They promised to have all the paperwork submitted to my insurance company that first week in Sept and will schedule my surgery as soon as its approved.

[Kaj 88]

So just a quick follow up to this. My current physician is willing to take my initial visit with my old PCP and count it as month one of the three month supervised weight loss. I will finish all my pre-surgery requirements on 3 Sept. I was advised that 1 Sept I should start my two week pre-op diet. I am on a bit of a time crunch' date=' so I need to move forward with surgery quickly. The hospital is working with me. They promised to have all the paperwork submitted to my insurance company that first week in Sept and will schedule my surgery as soon as its approved.[/quote']

So glad this is working out for you!

[cms213 119]

I had a 6 months supervised diet and on the 6 visit I was able to submit my final paper and have the final appointments with my bariatric clinic. I asked that same question and no one would give me a clear answer so I figured well if they deny it ill go another month but everything was approved