Approvals with BCBS Federal

[NewLife1985 45]

^@@MeFirst

^{WOOOOOHOOOOO! Congratulations! Im so happy for you! My last appointment is tomorrow!}

Edited February 17, 2016 by NewLife1985

[MeFirst 65]

^@@MeFirst

^{WOOOOOHOOOOO! Congratulations! Im so happy for you! My last appointment is tomorrow!}

I just got my surgery date!! March 14. .

Any news, NewLife?

[NewLife1985 45]

Awesome!!! Not yet! Insurance has had it since 2/18... so I'm just waiting....

[MeFirst 65]

It took exactly 1 week. So you might be close!!

Did you call BCBS Fed to confirm they got everything? I would if you haven't.

[NewLife1985 45]

@@MeFirst

I WAS APPROVED TODAY!!!! YAY!!!

[MeFirst 65]

@@MeFirst

I WAS APPROVED TODAY!!!! YAY!!!

Woooohoooooo!!! Gotta love BCBS Fed!! Congrats.

[Faytona 10]

I am so glad all of you had such a WONDERFUL experience w/ FEP BCBS.

Here's my story: I had a lap band in 2005 that I paid cash for here in the US. I LOST a 132 pounds I kept my wait off even after my port broke. I had some weight gain and had my port repaired in 2012. It has not been right since that time and last April I suffered my first slip....So in April of last year my doc scoped me and unfilled my band. In a month my band returned to position and a way I went. I haven't felt well since April and in November I went and saw my surgeon and decided to go for a sleeve as I am now having on going issues w/my band. When I feel I slip I go back on Clear liquids and my band calms down(I am 3 hours from surgeon and am a nurse), So they submitted everything to my primary Insurance the end of November and I was approved on 12/5....However here is the catch My doctor was approved but not the hospital.

So now here I sit 2 doctors later and a surgery date coming up on March 1st about 5.5 hours away from home. So now please realize I have 2 insurance and BCBS is not my primary. So I literally saw the doctor on the 2/2/15 and was approved on 2/3/15 by my primary. So when they went to submit it to FEPBCBS. Which most offices and Insurance companies here is the 21st century accept electronic records or faxes. FEP BCBS said...OH NO HUH-UH, you have to go to the post office and mail those records to us.(Ya know????SNAIL MAIL). People, the government if fining hospitals who are not getting on board with ELECTRONIC MEDICAL RECORDS and FEP BCBS won't accept a PRE-DETERMINATION electronically or fax??????????? Wouldn't you think this would be important as I AM having a serious complication from my device???????? REALIZE the codes for bariatric surgery are all ELECTIVE procedures no matter WTH is going on with a person.

So the representative asked when my surgery date was and she assured my coordinator that they would NOT get to my approval that soon since it is a PREDETERMINATION and they don't have to give a time frame since it is a PRE DETERMINATION! Plus, she wanted to make sure the coordinator is familiar with the FEP BCBS guidelines and that they more than likely would want to meet all of FEPBCBS criteria again. THERE GUIDELINES ARE BS. They have no clause in there GUIDELINES for complications of a bariatric surgery....SO I have to meet the same criteria of someone who is either a failed Bariatric surgery(even though I lost 132 pounds) or a new Bariatric surgery....My BMI is 35 - 39 this year. They don't consider my comps complications(plantar fasciitis) or I would have to have a BMI over 40!(FORGET THAT!)

In my H&P due to my intermittent lap band slippage I am at risk for necrosis and other life threatening issues. I feel like CRAP! My primary insurance recognizes this and approved me, ( I walked out of the office at 3:30 and got an email the next morning at 7:00 that I was approved) within 14 hours! I am really glad you all feel really supported by the FEP BCBS because the gals answering the phones won't do anything but quote the damn manual and I don't fall into any of there categories and they won't put a RUSH on anything or for anyone.

So my primary insurance is covering it but I have a 5000/copay. So hopefully I will be feeling better in a couple of weeks....if you are curious or care Medicare, VA and multiple other insurances have a provision in there GUIDES for complications arising from a prior surgery. God forbid any of you experience a complication and need a revision of your bariatric surgery! Because when the office calls to get pre-auth they are going to be quoted the manual and you will be expected to meet all of that criteria again(Seems ludicrous to me) then they will have to MAIL your records for your pre determination!......Good LUCK everyone and GOD BLESS! Sorry for the NOVEL but I am angry! I know I know at least I have insurance!

Edited February 27, 2016 by Faytona

[wileyns 16]

I have federal bcbs and I was just approved 2/25 took about two weeks to hear back surgery is in April :-)

Sent from my iPhone using the BariatricPal App

[Faytona 10]

wileyns that is awesome. Are you a revision????

[wileyns 16]

No this is my first surgery

Sent from my iPhone using the BariatricPal App

[MeFirst 65]

wileyns that is awesome. Are you a revision????

I'm a lapband revision. BCBS Fed approved my lapband in 2/2011, port replacement in 3/2013, and lapband removal 11/2013.

I just got approved to have the sleeve (surgery scheduled for March 14!!). However, I did have to go through the 3 month supervised diet, psych eval, and all pre-op tests again.

[Faytona 10]

wileyns that is awesome. Are you a revision????

I'm a lapband revision. BCBS Fed approved my lapband in 2/2011, port replacement in 3/2013, and lapband removal 11/2013.

I just got approved to have the sleeve (surgery scheduled for March 14!!). However, I did have to go through the 3 month supervised diet, psych eval, and all pre-op tests again.

My surgery coordinator just emailed me. They submitted my paperwork yesterday (February 9)!!!! Keep your fingers crossed for a speedy approval!

When should I start calling BCBS and asking about it?

Woohoooo!! Approved today!! I meet with my surgeon next Tuesday and set up a surgery date then. It's getting real!!! ????????????

^@@MeFirst

^{WOOOOOHOOOOO! Congratulations! Im so happy for you! My last appointment is tomorrow!}

^@@MeFirst

^{WOOOOOHOOOOO! Congratulations! Im so happy for you! My last appointment is tomorrow!}

I just got my surgery date!! March 14. .

Any news, NewLife?

Sent from my VS980 4G using the BariatricPal App

[NewLife1985 45]

^@@MeFirst

^{WOOOOOHOOOOO! Congratulations! Im so happy for you! My last appointment is tomorrow!}

I just got my surgery date!! March 14. .

Any news, NewLife?

My surgery date is March 15th!!!! Sleeve sistas!!! Lol

[MeFirst 65]

^@@MeFirst

^{WOOOOOHOOOOO! Congratulations! Im so happy for you! My last appointment is tomorrow!}

I just got my surgery date!! March 14. .

Any news, NewLife?

My surgery date is March 15th!!!! Sleeve sistas!!! Lol

Oh my goodness!! Congrats Sleeve Sista!!

Did you start your pre-op diet? I started yesterday. It's not terrible except my head is pounding!!

[NewLife1985 45]

@MeFirst

I started today! I'm hungry or anything I just have a MASSIVE headache! and I feel real nauseous! I think I'm having CARB withdrawals... I wish I could take a nap! LOLI hope it gets better!