BCBS HMO Blue

[Wisteria75 0]

Hi All,

I had my first consult with Dr. Fiallo at PVSA in May. I've done all their guidelines and they put the pre-approval forms through my insurance on 8/28/09.

Does anyone have BCBS HMO Blue? If so, how long did they take to approve you?

Thanks,

Wisteria

[Wisteria75 0]

Hi All,

I had my first consult with Dr. Fiallo at PVSA in May. I've done all their guidelines and they put the pre-approval forms through my insurance on 8/28/09.

Does anyone have BCBS HMO Blue? If so, how long did they take to approve you?

Thanks,

Wisteria

To answer my own question, for those people waiting for BCBS, it took about three weeks to a month to get approval! :thumbdown:

[bostonmomma 1]

this is pretty good news! I have BCBS hmo blue...here in Boston and I am juuuuust starting this process. I go to the informational in October and we go from there.....Can I ask what your bmi was and if you needed any other "comorbidities?" to qualify.....What else does hmo blue require prior to surgery? Now I am curious! LOL

:mad:

[alicia3138 1]

hello. this is good news for me too! i'm almost done with my tests and once i get approved into the program i meet with the surgeons and set a date, then hopefully get approval from BCBS HMO. Someone told me BCBS of MA is pretty good at approvals - I'm hoping this is true for me!

[bostonmomma 1]

so what tests did they want done? I am wondering if I can call my pcp and ask to have some of them scheduled now...while waiting for the info seminar. Probably jumping the gun.....but hey? My bmi is "only" 38...LOL...but my doc thinks that with PCOS and being medicated for anxiety/depression might get me approved.......wondering if that is true?

[alicia3138 1]

so what tests did they want done? I am wondering if I can call my pcp and ask to have some of them scheduled now...while waiting for the info seminar. Probably jumping the gun.....but hey? My bmi is "only" 38...LOL...but my doc thinks that with PCOS and being medicated for anxiety/depression might get me approved.......wondering if that is true?

well it depends on what you have and how you answer the questions in the packet. and i think it all needs to get done through the bariatric department. but the tests i had was a full blood/urine test, a PFT for asthma, dietician, social worker, and gallbladder ultrasound (my last test, next week!!). if you have sleep apnea you'll need to get a sleep study done. and there are a number of other tests too. so, it depends on what you have.

well they have a list of comorbs that you would need if your BMI is below 40...here is a link to the BCMS medical policy

good luck!

http://www.bluecrossma.com/common/en_US/medical_policies/379_Medical_and_Surgical_Management_of_Obesity_including_Anorexiants_prn.pdf#page=1

[Wisteria75 0]

this is pretty good news! I have BCBS hmo blue...here in Boston and I am juuuuust starting this process. I go to the informational in October and we go from there.....Can I ask what your bmi was and if you needed any other "comorbidities?" to qualify.....What else does hmo blue require prior to surgery? Now I am curious! LOL

:tongue2:

Hello!

Sorry it has taken a while to get back you. My BMI is 41.5% and I have prediabetes which I take medication for, asthma which I use an inhaler, acid reflux, which I take medication for, and sleep apnea where I use a CPAP machine, so yeah, I was well qualified.

With my plan, I had to have a 35% BMI with two comorbities OR a 40% BMI or over. That's it. They didn't need me to a 6 month weight loss plan at all like some of the people on here. It's quite simple actually.

So basically, BCBS didn't need anything from me... it's PVSA that needed me to have the appointments and stuff to be qualified then when that was finished they sent in the pre-auth form.

Yes, BCBS is pretty good with approvals. Dr. Fiallo said so himself as well.

Best of luck to everyone!

[innwtitdtity 57]

I haveBCBS HMO Blue. I had no co morbidities but my BMI was 42. No problems getting surgery approved.

[alicia3138 1]

I haveBCBS HMO Blue. I had no co morbidities but my BMI was 42. No problems getting surgery approved.

How long did it take the get the approval from BCBS?