BCBS of Il 6 month or no 6 month?

[healthydreams68046 3]

Hey all!

I'm super new and I am going through the approval process with my surgeons office and I have a quick question about my insurance.

I have BCBS of Illinois, and i'm getting conficting information from them about whether the 6 month medically supervised diet is required before my surgery or not.

I call them and the people on the phone at BCBS tell me YES I have to do the 6 month diet before they will consider approving me but I talked to billing in my surgeons office and she tells me NO I need to get it in writting that its a requirement and accord to the latest policy information regarding bariatric surgery for BCBS of ILL it is NOT a requirement.

So my question is do I go by what the insurance customer service reps are telling me or by what the actual policy info is telling me? October will mark month 3 for me working with this and my surgeon's office wants to submit my surgery through the insurance then for approval and I don't want them to if the insurance company is just going to automatically deny me because I'm not at the full 6 months..Any and all info/advice welcome. Thank you!!

[BBdoodle 483]

I have Horizon BC/BS in NJ and I did not have to do any pre-op diet. My weight was 216 and BMI was 36.. my surgeon submitted on a Monday and I was approved on Thursday. They were pretty quick, plus my surgeon knew EXACTLY what the ins. co. needed for approval. It was smooth sailing

[healthydreams68046 3]

I have Horizon BC/BS in NJ and I did not have to do any pre-op diet. My weight was 216 and BMI was 36.. my surgeon submitted on a Monday and I was approved on Thursday. They were pretty quick, plus my surgeon knew EXACTLY what the ins. co. needed for approval. It was smooth sailing

Awesome! Such great news. :-) Fingers crossed mine is as quick and painless as yours. Thank you very much.

[M.A. Cruz 15]

I have Horizon BC/BS in NJ and I did not have to do any pre-op diet. My weight was 216 and BMI was 36.. my surgeon submitted on a Monday and I was approved on Thursday. They were pretty quick' date=' plus my surgeon knew EXACTLY what the ins. co. needed for approval. It was smooth sailing [/quote']

I have the same exact ins and will be submitting my paperwork by the first week of oct once I'm done with all the specialists.

[BBdoodle 483]

I have the same exact ins and will be submitting my paperwork by the first week of oct once I'm done with all the specialists.

My surgeon kind of worked backwards.... after the consult we scheduled the surgery date, it was two months out. I needed a sleep study, colonoscopy, endoscopy, a nutritional and pysc. eval, and a letter from my general physician, once all of that was in then they submitted. I have a PPO and not a HMO plan.

Good luck.. you should do fine !!!

[M.A. Cruz 15]

My surgeon kind of worked backwards.... after the consult we scheduled the surgery date' date=' it was two months out. I needed a sleep study, colonoscopy, endoscopy, a nutritional and pysc. eval, and a letter from my general physician, once all of that was in then they submitted. I have a PPO and not a HMO plan.

Good luck.. you should do fine !!![/quote']

I have an EPO PLus plan. All that's required according to my surgeons office is psyh evaluation, pulmonologist clearance, cardiologist clearance, and nutritionist consultation/ clearance.

[terry1118 1,274]

I have BCBS of RI. They required a documented failed weight loss. I did Optifast four years ago and BCBS paid the biweekly doctor visits and labs so it was an undisputed fail. After completing all my requirements I was approved in three days. :-)

[SD2013 13]

I have BCBS of ILL as well. I was required to have a 3 month supervised diet. It all depends on what your employer and what they have for a plan...that's what I've been told. I will have my last visit for my 3 month requirement this comeing Tuesday. Keep your fingers crossed it all goes according to plan.

[YoColeFleet 246]

Hey all!

I'm super new and I am going through the approval process with my surgeons office and I have a quick question about my insurance.

I have BCBS of Illinois' date=' and i'm getting conficting information from them about whether the 6 month medically supervised diet is required before my surgery or not.

I call them and the people on the phone at BCBS tell me YES I have to do the 6 month diet before they will consider approving me but I talked to billing in my surgeons office and she tells me NO I need to get it in writting that its a requirement and accord to the latest policy information regarding bariatric surgery for BCBS of ILL it is NOT a requirement.

So my question is do I go by what the insurance customer service reps are telling me or by what the actual policy info is telling me? October will mark month 3 for me working with this and my surgeon's office wants to submit my surgery through the insurance then for approval and I don't want them to if the insurance company is just going to automatically deny me because I'm not at the full 6 months..Any and all info/advice welcome. Thank you!![/quote']

I have BCBS of IL as well and it only took me about two months for everything including an approval, I don't know if having PPO is different from HMO, hope this helps, oh and by the way, when my info was submitted to insurance company I weight 230 with a BMI of 40.1 with at least 5 co morbidity, I hope this info help.

[TxDumplin 69]

I have bcbs of illinois ppo and did not have to do the 6 month diet. All i had to do was the psych eval and meet with a dietitian one time. My surgeons office was able to tell me that on my first visit. Good Luck

[kkelly37 21]

I have bcbs il through ups and don't have to do it!!

[kpayton81 9]

All I did was turn my receipts for weight watchers and the gym in to my suregeon. Between his office and my pcp they worked it all out. Got my approval in less than 24 hours. I too have BcBS il. My surgery 8/30/13. Good luck to you.

[bdubbya 0]

Hey all!

I'm super new and I am going through the approval process with my surgeons office and I have a quick question about my insurance.

I have BCBS of Illinois, and i'm getting conficting information from them about whether the 6 month medically supervised diet is required before my surgery or not.

I call them and the people on the phone at BCBS tell me YES I have to do the 6 month diet before they will consider approving me but I talked to billing in my surgeons office and she tells me NO I need to get it in writting that its a requirement and accord to the latest policy information regarding bariatric surgery for BCBS of ILL it is NOT a requirement.

So my question is do I go by what the insurance customer service reps are telling me or by what the actual policy info is telling me? October will mark month 3 for me working with this and my surgeon's office wants to submit my surgery through the insurance then for approval and I don't want them to if the insurance company is just going to automatically deny me because I'm not at the full 6 months..Any and all info/advice welcome. Thank you!!

if u go on the bcbsil website it will tell you that you have a 6 month waiting period before u can get the surgery approved or pay the $1,000 penalty. they have the entire process outlined there. my surgeon is reporting my visits and everything to them so that all is covered, reported to ensure I meet all their requirements b4 I do this.

[kkelly37 21]

I have bcbsil and I don't have to pay anything at all and I do not have the waiting period. I was approved after a month. Every plan is different. Depends on what your employer sets up.

[healthydreams68046 3]

Well my surgeons' office just emailed me yesterday and let me know they submitted my surgery to the insurance on Friday 10/18/13.

Fingers crossed for a fast and easy approval! I only had 3 months of dr's visits, my psych eval, and 5 years of weight history.