PA Highmark, BCBS....advise/help!

[cls5186 23]

Hey all, it's me again...still confused and looking for help.

So i live in PA and have Highmark BCBS insurance, this was my second month of supervised weight loss/exercise PCP visit. My question to anyone who is or has had sleeve or bypass surgery with this insurance, do i need 6 consecutive monthly visits with a dietician as well? The insurance requirements is so vague and i can't get a straight answer when i call my insurance company. It's frustrating and confusing, anyone able to offer help? I had a consultation with a dietician who gave me a nutrition plan to follow, she also read the requirements and said it looked like only a consultation was enough along with 6 monthly PCP appointments.

Help!!

[vamping 183]

I have a different BCBS, but if it were me, I'd give them a call or send a secure message if you have a portal and have them clarify.

[KristenLe 5,979]

@@cls5186 I could never get an answer from BCBS of RI about the requirements. After several weeks, they told me to ask the surgeon's office. ????.

Your PCP might be able to find out specifics. Highmark does have some stuff online though. The 6 month supervised diet must be supervised and monitored by a physician but working in cooperation with dietician. My Bariatric Program has a NUT on staff so it was the surgeon who supervised it.

[cls5186 23]

Thank you ladies! I'm calling and demanding someone answer this question, it's so ridiculous. I have my first appt with my surgeon early next month, they seem familiar with all types of insurances so I'm praying they know

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[thisgirlhunts 94]

I have Highmark BCBS in PA. I met once with the surgeon (initial consultation), 6 times with my NUT (and weighed in each time to track what the insurance required me to lose), once with the exercise physiologist, and then another visit with the surgeon about 2 weeks out from my surgery.

My surgeon's office staff was very helpful in explaining all the insurance requirements during my initial visit.

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[cls5186 23]

Exercise physiologist? Hmm, my plan doesn't say anything about that. I called and got some info today, she told me 6 times with you PCP or NUT or like 3 and 3

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[thisgirlhunts 94]

I think every surgeon's practice is different. I don't believe it was an insurance requirement; just a requirement for my surgeon. But the exercise physiologist did help me with a pre-op exercise plan and I can consult with him (and the NUT) as much as needed post-op.

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[Nana1222 159]

I called my BC/BS in Iowa and they said they can't release that info to call the surgeons office. Surgeons office said Surgeon will tell me what I have to do when I meet with her in Oct. So I'm just going to wait and get answers then.

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