Highmark BCBS PA

[Misha42000 64]

Anyone have issues getting approved?

[hopekate 85]

I have Highmark and was approved in March and had no problem. It took under a week.

Good luck![emoji256]

[Misha42000 64]

Did you have to do a 6 month supervised diet and how long did it take you to get approved once you submitted your paperwork?

[hopekate 85]

My dr office didn't know that Highmark changed their policy about the six month wait, so four months in I found out about the change thanks to this forum! I called the office and they submitted my paperwork right away. I believe it was less than a week to get approved. I received the approval from Highmark via mail and had to let the office know.

[Misha42000 64]

Thats great news.

[Smores 56]

That's who I have. I'm just in the early stages of my journey. I was pre approved through the insurance but the final approval has not happened yet.

[Misha42000 64]

I didn't know there were 2 stages of approval.

I only have my psych eval left and then my surgeon's office is going to submit everything to Highmark BCBS of PA for approval.

I did confirm that in 12/16 they decided to get rid of the 6 month supervised diet

[hopekate 85]

I did not have a pre approval. Perhaps it depends on the particular plan. I have Highmark commercial through my husbands employer here in Erie. The only thing I did was to call Highmark to make sure they covered gastric surgeries. After that, the doctor's office took care of the rest.

I was sooooo happy that they dropped the six months!!

[klingie84 91]

No pre-approve for me either. Surgeon sent it all in after I completed the requirements.

[Misha42000 64]

I'm praying it will be approved for me as well.

[Smores 56]

I guess I said it wrong. They called BCBS and they said they covered the surgery. It's not really a pre approval. I miss spoke. Sorry.

[beege42 2]

Just had surgery and I have highmark BS here in PA. Finished the 6 mo nutrition classes and psych eval plus other clearances. I was worried cause bmi was 38 and my other health issues were all borderline with little treatment or medications to date but it was approved in 3 days and I had surgery last week! One hospital said I wouldn't get approved and I went through another hospitals weight loss center last august and now I'm post op!

[Misha42000 64]

I thought they didn't require the 6 month nutrition classes.

[Smores 56]

I hope not. I was hoping to get the surgery in July.

[Misha42000 64]

I did check and they revised the medical policy G-24 for gastric sleeve on December 2016 and they No Longer require the 6 month supervised diet.