Mggr14 3 Posted October 29, 2014 ANY ONE HAVE BCBS OF NORTH CAROLINA HOW DID THE PROCESS GO WITH THEM IM JUST STARTING ON MY JOURNEY AND WANT TO KNOW WHAT TO EXPECT. ANY INFO WILL BE HELPFUL. THANKS IN ADVANCE Share this post Link to post Share on other sites
beachgurl84 456 Posted October 29, 2014 I have BCBS NC and I'm 3 weeks preop. I started this journey back in June. As of July 1, they eliminated the 6 month diet requirement. I was a smoker so my surgeon required 90 days nicotine free (I'm 11 weeks yesterday) which is what has taken me so long. Honestly, I just did everything my surgeon's office required of me which included blood work, ekg, psych, NUT (psych and NUT are both required by BCBS too), ekg, & chest xray. Plus 3 nicotine test 30 days apart. As soon as I had everything done besides the nicotine test (I had one done at that point) my surgeon's office submitted me for approval. I didn't even know they did that because I thought I would have to wait till the 3 nicotine tests were done. I only found out they even submitted me because my surgeon's office called to tell me I was approved and to schedule my surgery. So I can't offer any advice on how long the wait was but I can tell you that just by doing what my surgeon required, I was approved no problem. My out of pocket max is $1500 and I'm at $1200 just getting everything done pre-op so my surgery will only cost me about $300 (plus the OUTRAGEOUS monthly premium). Share this post Link to post Share on other sites
Mggr14 3 Posted October 29, 2014 @@beachgurl84 THANKS FOR THAT IT GIVES ME A PRETTY GOOD IDEA OF WHAT TO EXPECT I ALREADY HAVE GONE TO MY INITIAL CONSULTATION AND THE FIRST THING I NEEDED TO DO WAS GET A COMPLETE PHYSICAL BC I HAVENT HAD ONE IN A WHILE (I know that sounds crazy) IF YOU DONT MIND ME ASKING WHO IS YOUR SURGEON IM NEAR THE COAST AND REALLY DIDNT HAVE MANY OPTIONS UNLESS I TRAVELED TOO FAR. IM WITH ONE OUT OF WILMINGTON. Share this post Link to post Share on other sites
beachgurl84 456 Posted October 30, 2014 @@Mggr14 I'm actually having my surgery in PA. I'm up here working until next January. I do however live in Wilmington so I will be visiting the bariatric COE at CF Regional I think for any long term follow ups. My cousin just had hers done in Charlotte but I don't know the name of her surgeon. Share this post Link to post Share on other sites
dgross 32 Posted October 30, 2014 Who is doing ur surgery in pa that is where i am from Share this post Link to post Share on other sites
juliedee 11 Posted November 15, 2014 I have BCBS NC and I started my process in September and got a surgery date for January. I'm actually approved & ready to go right now, but my surgeon didn't have any more openings this year, so I'm actually his first surgery of 2015! BCBS NC has waived the 6 month supervised diet, but they told me that I had to use a Center of Excellence, which gave me 2 places to choose from. Now, the Center of Excellence I'm required to use did have some requirements before they submitted me to insurance for final approval. I'm using Wake Forest Weight Management Center in Winston Salem. They required 2 nutrition classes, meet with a psychologist, and meet with their exercise team. Then the surgeon required an upper GI first, but I'm sure any pre-op tests are depending on what your surgeon feels you need. I know others who have needed sleep tests or colonoscopy, but all I had to do was the upper GI required of everyone. I'm not sure if all Centers of Excellence across NC have the same requirements, but that was my experience. Overall, it was a quick process and I have had no problems at all with insurance. Now it just comes down to waiting for me, and I have to adhere to my 3-week pre-op diet over the Christmas holidays and my birthday! Good luck on your journey and I hope it is easy & quick for you, too! Share this post Link to post Share on other sites
beachgurl84 456 Posted November 15, 2014 Who is doing ur surgery in pa that is where i am from Dr. Ramanathan @ Magee in Pittsburgh Share this post Link to post Share on other sites
Mggr14 3 Posted November 15, 2014 @@juliedee thanks thats really good information. good luck to you also! Share this post Link to post Share on other sites
nesheag101 8 Posted October 28, 2015 I have BCBS NC and I started my process in September and got a surgery date for January. I'm actually approved & ready to go right now, but my surgeon didn't have any more openings this year, so I'm actually his first surgery of 2015! BCBS NC has waived the 6 month supervised diet, but they told me that I had to use a Center of Excellence, which gave me 2 places to choose from. Now, the Center of Excellence I'm required to use did have some requirements before they submitted me to insurance for final approval. I'm using Wake Forest Weight Management Center in Winston Salem. They required 2 nutrition classes, meet with a psychologist, and meet with their exercise team. Then the surgeon required an upper GI first, but I'm sure any pre-op tests are depending on what your surgeon feels you need. I know others who have needed sleep tests or colonoscopy, but all I had to do was the upper GI required of everyone. I'm not sure if all Centers of Excellence across NC have the same requirements, but that was my experience. Overall, it was a quick process and I have had no problems at all with insurance. Now it just comes down to waiting for me, and I have to adhere to my 3-week pre-op diet over the Christmas holidays and my birthday! Good luck on your journey and I hope it is easy & quick for you, too! I am at WFBH-WMC as well! Had UGI today which made me nauseous ???? NUT Class next week and Psych on 20th! Ready for this! Pray all goes well for you! Share this post Link to post Share on other sites