BCBS NC 6 Month Supervised Diet Maybe Changing as of July 1, 2014

[beachgurl84 456]

I have BCBS CA (though I'm in a different state) and my pan doesn't require the 6mo supervised diet either, as far as I can tell. I did call to clarify but they were about as clear as mud. My surgeons office called and the only requirement was a psych evaluation and past weight loss attempts. Just did the evaluation and hoping that means we'll submit for approval by August.

Hi Lexibelle,

I did a quick search for you just like I did for our policy. I googled "BCBS CA Corporate Medical Policy". I found the BCBS CA list of medical policies that have requirements before approval. Here is the link:

https://www.blueshieldca.com/provider/authorizations/clinical-policies/medical-procedures/policy.sp

Where as NC list it as "Surgery for Morbid Obesity," CA list it as "Bariatric Surgery." PLEASE DOUBLE CHECK your plan because from what I see, your plan does require 6 months (pg 3) . I'm sorry, I'm not trying to get in your business or anything. I just know I had one heck of a time sorting out the "mud" in the NC policy and if someone had pointed me in the right direction I would have been grateful. Good luck to you and please let us know what you find

[Lexibelle 18]

I have BCBS CA (though I'm in a different state) and my pan doesn't require the 6mo supervised diet either, as far as I can tell. I did call to clarify but they were about as clear as mud. My surgeons office called and the only requirement was a psych evaluation and past weight loss attempts. Just did the evaluation and hoping that means we'll submit for approval by August.

Hi Lexibelle,

I did a quick search for you just like I did for our policy. I googled "BCBS CA Corporate Medical Policy". I found the BCBS CA list of medical policies that have requirements before approval. Here is the link:

https://www.blueshieldca.com/provider/authorizations/clinical-policies/medical-procedures/policy.sp

Where as NC list it as "Surgery for Morbid Obesity," CA list it as "Bariatric Surgery." PLEASE DOUBLE CHECK your plan because from what I see, your plan does require 6 months (pg 3) . I'm sorry, I'm not trying to get in your business or anything. I just know I had one heck of a time sorting out the "mud" in the NC policy and if someone had pointed me in the right direction I would have been grateful. Good luck to you and please let us know what you find

Thanks, though I guess mine is technically Anthem now that I look at my website. These are my requirements: http://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm

I contacted them because of the 'proof of past weight loss attempts' and how vague it was. That's what they were about as clear as mud about. I basically got told, well - we won't know exactly what you'll need until it goes to the review board. Blah!

I'm thinking positive and hoping that my weight + multiple co-morbidities + surgeon's analysis of my past attempts will be enough to satisfy them.

[BetterNai88 54]

Woooohhhoooooo it's official

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[KatieD6982 68]

I have BCBS Highmark (live in PA) anyone have that insurance?

[beachgurl84 456]

<p>I have BCBS Highmark (live in PA) anyone have that insurance?</p>

I have bcbsnc but I'm having my surgery in PA. My surgeon's office specifically mentioned high mark having the 6 mo requirement and being difficult about approval. I don't know why, that's all they said.