Blue Cross California

[tenten 0]

If you have this insurance, how long did it take you to get approved?

[Blund 0]

I have BC of CA, but live in Michigan. I'm getting excited about my first appointment with the surgeon, so I called BC and they told me 5 days max for review. Thats if they dont request anything more. There is a seperate 800 # for that dept on the back of my card.

[tenten 0]

Thanks. Good luck to you. When do you see the surgeon?

[kjw 0]

If you have this insurance, how long did it take you to get approved?

I have Blue Cross CA (live in Orange County). I talked to them and they said as long as I have a referral it's no problem. My PMD told me it would be 6 months but the dietician said it wasn't necessary and it's up to her and the medical director. She said I should have the referral for the surgeon on 2/14. I hope she's right.

[Teresajo 0]

I have BCBS of California too. I had bad experiences with my doctor, the hospital, the shrink and the dietitian. But BCBS were very professional and either had the answers to all my questions or found the answers and called me back.

They have a very good site, Medical Policies & Clinical UM Guidelines . I printed all of the requirements for lap banding and took them with me to my primary doctor who I don't think had ever had a lap band patient. He went through it, wrote the right letters and made the preliminary appointments that I needed. It really helped things to go smoother and faster.

I had approval less than 6 weeks after I started the process. But because the dietitian and shrink didn't do their jobs it took longer to get the actual surgery date.

It doesn’t hurt anything to give the person at BCBS handling your approval a call to make sure everyone is on the ball. Because I called I knew when there was a problem, even before my surgeon office did.

Good Luck

[kjw 0]

That's a good idea to get a name at the insurance co. The times I've called they are very helpful and knowledgable. It's been such an easy process I am waiting for the other foot to fall. Thanks for the response. Are you in Iowa? I was born there.

[Blund 0]

I printed the policy from the website too, and NOWHERE does it say anything about a 6 or 12 month supervised diet. I'm so relieved. I've done hundreds of WL programs, but dont have the docs to prove it. The BC policy says that my Dr must state that I've done everything else. (Short of LBS or wiring my mouth shut!) That she thinks it will help me, blah, blah, blah. When I called the seperate 800# for claims review, I got through to a person right away, and she was very helpful.

I see my surgeon next Wed, the dietition next Thurs, and the shrink the following week on Fri. I'm excited, hopeful, but guarded until I get the BC approval!

[marathinner 1]

I have Blue Cross Cali and I got approved in less than 2 days!! I went to my orientation on November 28th and my sugery is next Tuesday. So the whole process for me took less than 2 months.

I know.....I'm very lucky!! Good luck to you!!

[tenten 0]

Good luck on your surgery. Keep us up to date!

[Blund 0]

Wow, 2 days? That IS fast! I'm sure my excitement now will turn into trepidation if I'm approved. After reading on here about pb-ing and only being able to eat 1/4 to 1/2 cup at a meal. Now when I eat, I actually think about that. There should be a home blood test to be sure you're getting enough nutrition.

Let us know how things go. Good luck!

[IndioGirl55 32]

If you have this insurance, how long did it take you to get approved?

About a week... My doc Office took care of all this -

I went directy to surgeon - 5/31 had tons of test due to age and never going to the doc - no supervised diet - was approved on 6/20 after shrink appoint on 6/14 - surgery 7/17

When I called them (bc ca) they said it was covered under my policies if medically necessary - bmi 42 - high blood pressure and slight sleep apnea.. I qualified

[cdyoliver 0]

Wow, you are all so lucky. I have Blue Cross/Lumenos.. The place I went to screwed up and I had to pay 15,000 cash. It upset me so much.. Does anyone know anything about appealing. The surgical center was suppose to help me but the didnt... It's been 4 months. Is it to late to appeal. I know if the surgical center were on the ball which I thought they were, they would have paid. I worked for Blue Cross! Just not that dept. I am not there any longer but still have Cobra... I am depressed and this is affecting my weight loss... Any suggestions???? Keep up the great work everyone.. You are inspiring to me... cindy Cdyoliver@aol.com

[Guest Bobbye1948]

The hospital weight loss program called and told me that my insurance had approved (blue cross ppo) minus $100 deductable. Have to have a phyc evaluation and nutrition evaluation. She said blue cross is mainly interested on how many weight programs/diets you have been on and how they worked for you. She said she had just come from a meeting with hospital and that they were going to be stricter with this information.

She said if you could put down all information about diet/programs you have used it would be very helpful.

I am going to my seminar in 3 days. Will report on progress.

[Blund 0]

RE: BC CA appeals....

I'm pretty sure there is an 800 # on the back of my BC of CA card for appeals, or you could call the 800 # for pre service reviews. Otherwise go to their web site. There is also information on the home forum page here regarding appeals processes in different states.....the 2nd or 3rd topic?? On the bright side, I've heard several stories of people getting denied, then getting quickly approved on appeal. I hope NOT to have to be in that boat. I still have to wait and see if I'm approved.

good luck

[WestCoastFatGuy 3]

It took less than a week from submission by my surgeon's office.