BCBS TX Submitting paperwork

[Coley21 0]

:w00t::cursing:I'm so frustrated!! 3 months ago my surgeons office told me that my ins. required 6 months of medically supervised weight loss treatment (within a 2 year span) before getting an appt...After calling my ins. co (bcbs of tx) they told me that Weight Watchers was accepted as supervised weight loss and my surgeon's office agreed...So now 3 months in I call my surgeons office as they told me to so that I could start my appts with them. I faxed over my WW paperwork and they call me today and said that I had to be having monthly visits with my doctor while I was doing weight watchers..She must have forgot to tell me that part!!!!! So now I'm back at square one...Starting all over again 6 months of medically supervised weight loss....I have to do 6 months now because the other 3 months I did with a Dr. will now be too out of date to submit by the time I do 3 more months of WW..Yay!!! Ugh!! Anybody have any info on this or has anyone gone through this before?

[Debbie P 0]

BC/BS sucks. Yes, I did. Good luck. Dot all I's and cross all t's, that's the best I can tell you.

[Jaculin412 0]

I have not had my surgery yet, scheduled November 24th. I've actually heard good things about BCBS (of NJ PPO). My surgeons office told me I had to do six months monitored which I am doing with my PCP, next week will be month 5 (woohoo!!) and I have two tests to be done by the gastro which I have scheduled for October 13th. Once I go to my PCP on November 6th (which is month 6) all her notes get copied along with a letter of necessity and they go to my surgeon. My surgeon then submits all documents, tests results, etc. to the insurance for approval. They gave me my surgery date when I went in for my surgical consult in July so I am assuming they know the drill and everything should go through smoothly. I'll keep you posted.

[downsdc 0]

I have BCBCTX also. I had the Gatric Band Institute in Chattanooga check and they said I had a specific exclusion in my policy on Gastric Surgery. So I am having to self-pay.

[hanes66 0]

Did BCBS of TX myself. Make sure that when you go to the weigh in at the doctor, it is the ONLY thing that they mark down on your chart. If while your in you have to get an antibiotic or anything else, and they mark it down on your chart that goes into BCBS then that appt doesn't count. I finished my dr's appts at the end of August, and submitted everything at the beginning of Sept. I do have to say that they were pretty go to me. I was really terrified that they would not approve me the first time. I had to have a sleep study done for my dr. I went to who they sent me to, spent the night, did everything that I was suppose to do, and the next month when I went to see my dr., he still did not have the results of my test. I tried to call the company that I went and they had permanently gone out of business. I tried to contact the director, and even the owner. My doc's office also tried to get my results, but had no luck. The only proof that i had was my benefits sheet showing that BCBS had paid for the sleep study. I had to submit a letter with the benefits info with all of my paper work. Apparently, that worked. Any tests that you have outside of your dr.'s office, get the results yourself so that if something happens to them, you have your results to submit. I went through LapBand Solutions, and they took care of ALL of the paper work in submitting to my insurance company. I never had to talk to them, or anything. I got my answer within about two weeks. Keep posting to let us know how it goes. Good Luck!!!

[Coley21 0]

Thank you very much for the info!