Help please...federal bcbs prior approval

[sallydee101 0]

The doctors office has reasured em this week I ahve one of the ebst possible coverages............cross your fingers the journey begins.

[MollyBrown 0]

I have BCBS Federal Basic. I called to ask if they covered the lapband and the fills. I got the codes from my surgeon's office before I called.

BCBS Federal said they could not tell me 100% on the phone that they would approve it, but if I was 100 lbs or more overweight with a BMI over 40, or if I was substantially overweight with one or more co morbidities, then it was likely they would pay for it. Also, BCBS Federal did not require the 6 month supervised diet or psych eval. The person told me to work through my surgeon's office. My surgeon's office gives everyone a packet, they want statements from all of your doctor's to support that your weight is causing you an issue.

My PCP wrote a letter, my cardiologist (I don't have a heart problem but there is VERY strong heredity issues and my weight makes me a target), I was pre-diabetic, pre-hypertensive, and just starting to get high cholesterol, mild sleep apnea, back problems and just starting to get foot and knee problems. I went to each of these doctors throughout the past year to be evaluated. They all wrote letters and faxed them to my surgeon ASAP. My surgeon's office submitted and within 4 days I received approval. I was freaked, I thought it would take so much time.

I owed the surgeon $100, and the hospital $100.

Good luck...