doingitforme29 8 Posted September 13, 2014 Does anyone have LG BCBS of Alabama? If so, I'm interested to know about your experiences with them and the approval process. I'm currently awaiting approval for the VSG and I've been extremely stressed about it. My surgeons office submitted dated photos along with the pre approval documents. It was either 3 years of height and weight records it dated photos, we chose dated photos. Has anyone else submitted pics for approval? Share this post Link to post Share on other sites
momohime 121 Posted September 13, 2014 I submitted pictures. I was initially denied, but that was to be expected because the approval process is apparently automated. Once my claim went to an actual BCBS agent, I was approved for surgery. It took about 3 weeks or so after I turned all my paperwork in to my surgeon's office to get the OK. Share this post Link to post Share on other sites
doingitforme29 8 Posted September 13, 2014 I received my initial denial letter yesterday, which the nurse told me it would happen. She basically explained to me exactly what you mentioned about the claims process being automated. She told me she would submit the claim that day, and that would automatically trigger the denial because the pics couldn't be sent until the next day. I'm currently awaiting approval. I'm so stressed about getting approval. Share this post Link to post Share on other sites
momohime 121 Posted September 13, 2014 I wouldn't worry! It takes a little longer with pictures, but BCBS definitely accepts them. Of course, I remember when I was in your position and was checking my email constantly for news from my surgeon's office! Seriously though, before you know it your surgery will be done and you'll be 4 months out and wondering where all that time went.. Trust me, it happens. Share this post Link to post Share on other sites
doingitforme29 8 Posted September 15, 2014 Thank you for responding to my post. I've been checking the mail daily and anxiously awaiting a call from my surgeon's office, hoping they have received my approval. I'm so nervous, it would be devastating if they were to deny me. I'm being very optimistic and praying for the best. I've been contemplating between the lap band and they sleeve and I've decided on the sleeve (I think). It took some time for my husband to become supportive of the lapband, so I was nervous today when I revealed my decision to get the sleeve to him. To my surprise, he was ok with it and stated he wanted me to be happy. The only person who hasn't been supportive of my decision is my mother. Did you have any issues with anyone not supporting your decision? Share this post Link to post Share on other sites
Monasongbird_38 73 Posted September 23, 2014 Well, I was approved 2 weeks ago and niether my surgeons' office nor myself have recieved any formal notification. I sumbitted three years of weight history and office notes. I am going crazy waiting for my surgery date....lol Share this post Link to post Share on other sites
doingitforme29 8 Posted September 23, 2014 @Monasongbird_38" Really!!??? Congratulations!!! It will be three weeks on Friday since my my surgeons office submitted my paperwork! I haven't heard anything since my initial denial letter which was expected because my dated photos were submitted a day after the other paperwork. How did you find out about your approval? Where in Alabama are you located? Who's your surgeon? Share this post Link to post Share on other sites
Monasongbird_38 73 Posted September 23, 2014 My surgeon is Dr. Turton in Columbus Ga. I called Bcbs a week after my Surgeon's insurance coordinator re-submitted my paperwork. Share this post Link to post Share on other sites
doingitforme29 8 Posted September 24, 2014 My surgeon is Dr. Turton in Columbus Ga. I called Bcbs a week after my Surgeon's insurance coordinator re-submitted my paperwork. I have local government employee BCBS of Alabama. It covers 50%, and I'm required to may the physician's fee, which is $1,057.00. I'm just hoping to be notified soon. I've been really stressed about it. Most insurances require 6 months of supervised dieting and seeing a nutritionist, I don't have to do that, I guess it balances out since I have to pay the physician's fee. My surgeon requires that I take a nutrition and pre-surgery course and attend one support group prior to getting a surgery date. Share this post Link to post Share on other sites
Nicole.Sprout 0 Posted September 30, 2014 So, I'm on BCBS AL/FEP, and going to meet with Dr. Mailapur tomorrow. I can get weight records for 2+ years, but my BMI didn't quite climb to 40 until this year. I am worried about having to get a letter from a primary care physician, too. Was that part of your approval package? Who did you see? I'm worried I'd get pushback from the family doc I use from time to time, and would really rather ask my OB, who actually knows me. Share this post Link to post Share on other sites
Nicole.Sprout 0 Posted September 30, 2014 So, I'm on BCBS AL/FEP, and going to meet with Dr. Mailapur tomorrow. I can get weight records for 2+ years, but my BMI didn't quite climb to 40 until this year. I am worried about having to get a letter from a primary care physician, too. Was that part of your approval package? Who did you see? I'm worried I'd get pushback from the family doc I use from time to time, and would really rather ask my OB, who actually knows me. Share this post Link to post Share on other sites
doingitforme29 8 Posted September 30, 2014 So, I'm on BCBS AL/FEP, and going to meet with Dr. Mailapur tomorrow. I can get weight records for 2+ years, but my BMI didn't quite climb to 40 until this year. I am worried about having to get a letter from a primary care physician, too. Was that part of your approval package? Who did you see? I'm worried I'd get pushback from the family doc I use from time to time, and would really rather ask my OB, who actually knows me. Like you, my BMI didn't climb to 40 until the last couple of years. Instead of physician documents, I submitted dated photos. I didn't have to get a letter from my primary physician. My paperwork had already been submitted prior to my recent gyno appt, however,after telling her about my decision, she provided my surgeon with documentation to support my need for surgery. I am also seeing Dr. Malipur. I found out I was approved today. I have an appt this friday for a weigh-in and to schedule a surgery date. Share this post Link to post Share on other sites
fairgge 3 Posted April 18, 2015 SOOOO grateful to see this topic, I can't even tell you! I have BCBS of Alabama, local government. And just to make sure I understand what everyone's saying - I don't have to do the 6 months pre-dieting, but I do have to have three years of medical records showing weight? Do I have that right? Does anyone know if I can go ahead and get the records and bring them to the first appointment, or does my surgeon's office need to get them? Thanks in advance for any help! Share this post Link to post Share on other sites
Monasongbird_38 73 Posted April 27, 2015 SOOOO grateful to see this topic, I can't even tell you! I have BCBS of Alabama, local government. And just to make sure I understand what everyone's saying - I don't have to do the 6 months pre-dieting, but I do have to have three years of medical records showing weight? Do I have that right? Does anyone know if I can go ahead and get the records and bring them to the first appointment, or does my surgeon's office need to get them? Thanks in advance for any help!Hey there!I have the same policy that you have. ....I actually got everything faxed as it was completed.....Psychological, PCP letter, 3 years office notes weight history ...it went pretty fast for me..feel.free.to inbox me with.any questions....I'm Yolanda Terry-Beasley on Facebook.< /p> Share this post Link to post Share on other sites
fairgge 3 Posted July 11, 2015 Hey again! I'm confused and hoping y'all can help! Having surgery next Friday, and I know I have to pay the surgeons fee at preop. But does the insurance cover the hospital and anesthesia and all that? Share this post Link to post Share on other sites