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BCBS Federal: share your experience!



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Hello to all....I am in the process of the pre-approval 3 month appointments with BCBS Federal. I am using Bluepoint Surgery Group in Northern VA.

Can anyone share your experience and tell me if there are any pointers in receiving approval? Were you turned down? Why and what did you do?

Thanks so much!

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With a BMI of 40.1 and several co-morbidities, I was approved by BCBS Federal Employee two days after my packet was submitted.

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Thanks to you both! Joat@@joatsaint the links are a great help.

S

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Hi Scoutsmom! I'm using Bluepoint as well...who is your doc? I have Dr Halmi. My experience has not been great, but that is because when I started my BMI was < 40 and BCBS did not accept my co-morbidities. It's a long story. I've been dealing with this since last March. (i am sure I am in the minority with the length of time it has taken; many of the problems were due to a comedy of errors on BP's part, & I switched surgeons yada yada yada)

Fast forward to present, I am waiting to hear on my last appeal. Other than that, they readily accepted my 3 month supervision & all other tests, etc. btw do you have Standard or Basic option? I have Standard. From what I've read on this forum & others, BCBS usually approves expediently if BMI > 40, & certain co-morbidities.

Good luck!

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Hi Peteyrulz,

I met with Pourshojae and liked him. But thinking of switching to Moazzez due to great feedback about him that I have read on this forum. I have BCBS Federal.

My BMI is under 40, which is why I am trying to insure I do everything possible to document the co-morbidities. I have a sleep study this week. Any thoughts on how to best document or present the co-morbidities so they are not rejected?

From what I can gather, Pam in the Fairfax office is the most knowledgeable and helpful.

Thanks for your reply!

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I have BCBS federal. My starting bmi was 36 with high blood pressure and later diagnosed with GERD. Took the sleep study but no apnea or abnormalities. There is no requirement to loose weight during the 3 months. I actually gained a few! Had no problem with approval because my history of hbp was well documented through years of treatment. I was approved in 5 days.

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Hi Scoutsmom! I'm using Bluepoint as well...who is your doc? I have Dr Halmi. My experience has not been great, but that is because when I started my BMI was < 40 and BCBS did not accept my co-morbidities. It's a long story. I've been dealing with this since last March. (i am sure I am in the minority with the length of time it has taken; many of the problems were due to a comedy of errors on BP's part, & I switched surgeons yada yada yada)

Fast forward to present, I am waiting to hear on my last appeal. Other than that, they readily accepted my 3 month supervision & all other tests, etc. btw do you have Standard or Basic option? I have Standard. From what I've read on this forum & others, BCBS usually approves expediently if BMI > 40, & certain co-morbidities.

Good luck!

did you have your surgery with Dr. Halmi? Or are you still in approval process? I just started the revision process with him.

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