Carrie D. 0 Posted November 23, 2007 Hi everyone... I am new here. I am living in Texas. I have TRS Active Care BCBS of Texas. I know that I have to have a 6 month physician supervised diet & 5 year history. I don't have any problem documenting the 5 year history through my PCP. However, I think I might have to go through the 6 month diet thing with my PCP. My question is, does the diet have to be an uninterrupted 6 month period of time? I'm questioning this because when I went to my PCP the other day, she asked if my 4 months with Weight Watchers and working out would count towards the 6 month requirement. I'm not sure, but I really hope so. That way, I'm thinking that I'll only have 2 more months to document...all of wh Which would put me right on track for my desired surgery date during Spring Break. Does anyone have any experience with TRS Active Care BCBS? Any suggestions or things to watch out for? Thank you in advance... Carrie Share this post Link to post Share on other sites
Just_A_Girl 0 Posted November 25, 2007 Hey Carrie, I also have BCBS TRS. I work for a school district in East Texas. I will be submitting my insurance paperwork on Monday, I hope. My goal is to have surgery over Christmas Break so that I don't have to take off any additional time. (I am sure you have the same thoughts about Spring Break) I hope that you can count what you have already done ... that would be great! Have you picked a surgeon yet .... Does he/she have a coordinator? That is who I ask all of my questions. She is used to dealing with these issues and all of the insurance companies. Post whatever you find ... I haven't been able to find anyone else on here with our type of insurance!! It is so nice to meet you! Alisha Share this post Link to post Share on other sites
bigbaby 4 Posted November 25, 2007 I am a teacher in Dallas with TRS Active Care. It is my understanding that as long as you have documentation, it's O.k. For example, I went to Jenny Craig and they were able to pull my files for documentation.(It didn't help me because I didn't stick to it for 6 consequetive months). I'm not sure about Weight Watchers because you keep the documentation and not them. Try and call the corporate office and see if they have documentation. Also, I used AIGB (American Institute for Gastric Banding). They were terrific and knew ALL of the answers to the insurance questions. Hope all goes well for you. Share this post Link to post Share on other sites
Just_A_Girl 0 Posted November 25, 2007 Thanks for the response. I am just praying everyday that I can have this surgery. I literally have dreams at night about being on my pre-op diet, forgetting about chewing, and how good it feels to be healthier. Silly huh. I swear these dreams are so real ... when I wake up I have to look at myself to see if I am smaller ... then I realize it was just a dream ... but hopefully not for long! I just hope I won't be denied. Have you told anyone about your band at work or elsewhere? Share this post Link to post Share on other sites
bigbaby 4 Posted November 25, 2007 There is absolutely NO SHAME for me!!!! Anyone who notices and asks what I am doing...I tell them that I had the lapband in June. I figure...Why lie??????? If they ask....I will tell!! Share this post Link to post Share on other sites
Carrie D. 0 Posted November 25, 2007 Hey Alisha... I work in East Texas too. Chapel Hill ISD to be exact. I have an appointment with Dr. Babineau on December 26th. It's the group meeting/individual consultation. I'm going with another teacher friend. She was hoping to have things done over the Christmas break, but we couldn't get in for an appointment until after Christmas. I'm hoping to have mine during Spring Break for two reasons...time off from school without taking personal days and tax refund money to pay my 20%. I've heard that Dr. B's insurance coordinator is fabulous and can get approval when you think there's no hope. I'm just a little impatient. I'm one of those people who that when I make up my mind about something, I want it done yesterday It's good to meet you too! Have you chosen a doc yet and do you have a surgery date? Share this post Link to post Share on other sites
Carrie D. 0 Posted November 25, 2007 Hi bigbaby... It sounds like the insurance company is wanting the 6 months to be consequetive. ARgh...that's a problem because I only went to Weight Watchers for 4 months. Well, I've also heard on another board that the 6 month diet history is not necessarily set in stone. Hmmmm....guess I'll just have to wait and see. Thanks for the response Oh, and what happened with your port? I noticed that you had a revision. Share this post Link to post Share on other sites
bigbaby 4 Posted November 25, 2007 With TRS BCBC--the 6 months was set in stone. I tried to use my Jenny Craig doc...but was unsuccessful. The six months will FLY by...just make sure that you make EACH and EVERY appointment. If you miss one, the 6 months begins all over. My port flipped. I received a small fill. Went in two weeks later and it was flipped. My doc says that sometimes it just happens...the body doesn't produce scar tissue fast enough to keep it in place, or I could have lifted something to heavy. I went in and he flipped it back and tied it down with barb wire (just kidding!!!!) I haven't had any problems!!! Share this post Link to post Share on other sites
