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BCBS of Ill, insurance questions..



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Hello All

I am working on getting ready to have my surgery and I need to get things ready, like paperwork from my general doctor.

BCBS needs to have a 5 yr medical history from my doctor however how detailed does this have to be? I have not ever gone to this doctor for weight issues just if I have been sick and of course my weight and such have been documented.

Does anyone know how this should play out with the 5 yr medical history? Please advise. I mean I have already gone through all my pre sugery testing and everything we are just waiting on getting this info back from the doctor so it can all be submitted to BCBS.

Thanks

Michele

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Hello for me BCBS wanted to see that I had a 5 year history of being overweight. They just wanted to see my weight history.

Best of luck to you on your surgery!

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BCBSIL will be looking for a history of morbid obesity coupled with prior attempts at successful weight loss. Your record of weighs during your normal visits will hopefully verify your overweight condition during this period. If your physician has recommended or prescribed and weight loss treatment for you during that period, ask him/her to find those records for you. Also, document anything you have done on your own ie: any formal weight loss program, exercise regimend, weight loss medications etc. You need to show that you have tried unsuccessfully to permanently loose weight.

If you have not been seeing your current PCP for five years, they should have your medical records from your former doctor. If not, have him/her request them.

Plan on BCBSIL jacking you around, it's just what they do. The more documentation you give them initially, the better.

Best of luck.

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Hi Michele,

I am not sure about your BCBS but I am with BCBS of MI and they require 6 mos of documentation from your primary doctor or a weight loss center in the last 4 years. I called the insurance company myself and had them fax me copies of the requirements for the surgery. It helped because now I should have everything that is required. I am on my 2nd week of 6 week classes that my surgeon requires before they will schdeule the surgry.

I hope this helps.

GOOD LUCK!!!

Stacy

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Below is the link to BCBSIL medical policy for bariatric surgery. It should open by clicking on it, If not, copy and paste it into your web browser address bar. I gives you all the requirements and details...Dan.

BCBSIL/Provider

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You didn't go to the doctor about your weight, but what does he do every time you walk in the door? He WEIGHS you and TAKES YOUR BP if nothing else. Relax. That's all they need.

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