Questions for bcbs patients...and other questions

[MSan914 3]

The differences in BCBS is actually the employer or policy holder. One company can create their own coverage plan which can differ greatly from another company's coverage plan.

So my BCBS coverage as a state of michigan employee is different from my neighbor's BCBS coverage as a employee of a hospital system.

[beaglemom 0]

I have been approved and schedule for May 21st!

I started all this back in November, not really sure if I was going to go lapband or not.

Did the insurance diet and while I was doing that, got the paperwork done. Have already been diagnosed with GERD, sleep problems, etc. so didn't have to have any of that testing.

Did have to go through pysch, hours of multiple choice questons.

Did my last visit on May 1st, paperwork was sent in on Wednesday and I found out through BCBS of Texas live chat that I am approve and have scheduled for May 21st.

So there you go.

[beaglemom 0]

By the way, if your insurance plan has a Live Chat -- the BCBSTX plan does, you can find out your status very quickly and easily.

That's how I was able to get the ball rolling so fast.

They got my paperwork Wednesday, approved it on Friday sometime between 9:00 and 1:00 and had the letter sent out by the end of the day.

I was able to get scheduled by the end of the day.

[paisleypea 1]

wow beaglemom - that is GREAT! I do have BCBS TX so I'm very interested in how this LiveChat thing works. Can you help me out?

I've been VERY discouraged recently becuz the surgeon's staff is 1) extremely hard to get hold of 2) the staff don't call me back except one time (out of 8 calls) and 1 email response (to 6 emails). i had a hard time getting my dr. records to her ---- the fax didn't work ---- but no one told me! so it has taken since April 15th to play phone call tag to find out if my records made it, then go back to my dr. and figure out their end --- I did this 3 times! Finally picked them up ourselves and faxed them ourselves. That was on May 1st --- that all the required paperwork was at the surgeon's office. she told me he was to write the letter and send it in. Called back yesterday 5/8 and he'll write the letter THIS weekend. I feel like I'm the only one who really wants this to happen! so frustrating.

also frustrating cuz on the 6-month dr supervised diet, he had me on phentermine, which required an EKG to check my heart. Just got a bill for the dr. visit in Feb. for $200 ---- cuz BCBS TX denied it cuz it was listed as obesity. ugh - didn't count on that at all!

so ---- I'm hoping that my paperwork really does get submitted next week, but I've thought that for 3 weeks now.

Plus I am afraid they'll deny me cuz I couldn't find 5 years of medical records of my highest weights where I could qualify as 5 years with BMI of over 35. I have been - but it's a roller coaster of gaining/losing the weight. I typed up a chart outlining dates and weights and which weight loss program I tried and the results (lost 20, lost 45 etc) hoping that will work.

thanks for letting me vent, no one else seems to understand this but here on this board. well, my husband does and he is supportive, thankfully!

[beaglemom 0]

wow beaglemom - that is GREAT! I do have BCBS TX so I'm very interested in how this LiveChat thing works. Can you help me out?

I'm glad I'm going with a company that all they do is lapband. Their people really have it together next to yours.

I will say that the primary care office gave us a bit of a blip, as they send two years of history, not 5, and I knew they had it. I had two other specialists that I see regularly that could help but didn't want to go there if I didn't have to.

As to BCBSTX. You have to go to their website www.bcbstx.com and register if you haven't. Once you register, you log in. You can do some really good things, like have your EOB's there instead of in the mail, etc.

The Live Chat is on the lower left hand corner, you click on that, put in your telephone number and then ask your question (there are some other clicks involved). They ask you for your date of birth, usually takes a minute or two and answer.

They have been very helpful, and I didn't have to go through what seems like hours of telephone button pressing.

[lose2regainme 0]

BCBS of IL (PPO). I have been roasting in insurance pergatory for almost a year. I clearly qualify, but I have been declined three times, the last time with the Obesity Advocates. BMI 41.2. A LIST of comorbities. 6 month medically supervised weight loss program completed before first filing. Met with and approved by Nutritionist and Psychologist. I have been attending the twice monthly support group meetings at the surgeons office since Oct. 08. The denial letters state different things as missing each time, but it IS ALL THERE!!!! I had to refocus my attentions over the last few weeks to knee surgery, now I am again gearing up for an appeal. I wish you the quickest, easiest approval ever heard of!!

I finally got an approval letter!!!!! After almost a year, I can't believe they finally said yes!!!!!

[MSan914 3]

Lose2regainme -- CONGRATS!!!!

Let us know when your surgery date is -- you must be SOOO excited!!!

[pickles123 0]

Boy this insurance stuff sounds like a real mess. I am just starting with everything. I hope I can figure it out. Reading all the threads has taken a long time but really helps. It sounds to me if you can get the doctor to contact the insurance it goes a lot easier than if you try to do it yourself. As much as I have read those that do it themselves have more hoops to jump through and it takes a lot longer to qualify. Does that sound right to all of you.

Good dieting

Pickles123