Anthem BCBS

[Tashagirlxo 41]

Hi guys! So I'm all done my requirements per my surgeon. I should be able to submit my information to the insurance this week. A couple things I wanted some opinions on. 1. I haven't gone to the doctor for 6 months so they could track my weight. 2. I'm not sure what state my insurance is out of?? I live in New Jersey so I'm really unsure. Any ideas?? I'm super nervous and after reading all these posts I feel like I'm going to get denied. I'm at 40 BMI, but I feel like they're going to want me to do a 6 month documented diet.

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[Tashagirlxo 41]

My doctor said they would type something up showing I tried a diet for 6 months but I feel like that wouldn't be sufficient?

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[blizair09 3,250]

I have BCBS Anthem. They required six monthly visits with the surgeon's nurse practitioner, 1 visit with the nutritionist, a psych evaluation, and a medical clearance from my PCP. The surgeon's staff took really detailed notes on my weight loss each month of the six months and submitted all of that documentation (it was a binder full of stuff). Nothing could be submitted until everything had been completed. lost 100 pounds during my six month pre-op program, was at exactly a 40 BMI on the day of surgery, and I was approved. It took 2 weeks from when they submitted the paperwork for BCBS to approve it.

[Tashagirlxo 41]

Wow thank you so much!

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[blizair09 3,250]

Wow thank you so much!

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My pleasure. Good luck!

[teedsg 253]

@@Tashagirlxo, not sure about this one because every insurance company and policy is different. I have BCBS of Michigan and I live in Georgia. The company I work for corporate office is in Michigan. They required 6 months nutritional visits with a nutritionist, PFT, chest X-ray, EKG, Certification/Letter of Support from PCP. I'm not done with all of my requirements, I have 2 more nutritional visits to go, but I'm going to try to get my PCP to submit my info this week. My surgeon is trying to get me to get it done before the end of the year, which I agree because I would have to reach my deductible all over again if it goes into next year.

However, I read on a post on BP that mentioned that they got approved for their surgery and they were on their 4 month visit. I also read on here where someone got approved just by using Weight Watchers online. I didn't even know that counted...Hope this helps. Crossing my fingers for you...

[Tashagirlxo 41]

@@teedsg I'm going to call them this morning to see if they can tell me which state my insurance is out of and go from there! If I don't need the 6 month supervised diet, then I can submit all my paperwork to the insurance within this week or so.

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[Clarevoyant 347]

I have BCBS Anthem. They required six monthly visits with the surgeon's nurse practitioner, 1 visit with the nutritionist, a psych evaluation, and a medical clearance from my PCP. The surgeon's staff took really detailed notes on my weight loss each month of the six months and submitted all of that documentation (it was a binder full of stuff). Nothing could be submitted until everything had been completed. lost 100 pounds during my six month pre-op program, was at exactly a 40 BMI on the day of surgery, and I was approved. It took 2 weeks from when they submitted the paperwork for BCBS to approve it.

Exactly the same for me. Had to go monthly!

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[Tashagirlxo 41]

So I got clarification this AM that my insurance is based out of Ohio. Cross your fingers for me guys! I should be going in soon to submit all my info

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[teedsg 253]

@@Tashagirlxo, that's awesome! Crossing my fingers and toes.