Approved by BCBS Federal Insurance revision from Lap Band or Sleeve to RNY?

Virgie Tschirhart
on 11/6/17 7:42 am - Midwest City, OK

I already posted this on the Revision and Insurance forums. Since there is more activity on this forum thought I'd ask here...

Just wondering how long should it take until I get my answer from them for my revision from the Sleeve to RNY?

I live in Oklahoma. This is going in as a medical necessity due to my hiatal hernia severe acid reflux. Since this is November would like to have my surgery before the year ends.

on 11/6/17 8:35 am
RNY on 11/21/14

Time lines for a response to a request for a prior authorization are governed by state and federal law. Which laws apply depend on the funding mechanism for the employer's plan (self insured vs fully insured). The only way to know for sure is to call BCBS at the number on your ID card and ask about your specific plan.

 Height: 5'7".  HW: 299, Program starting weight: 290, SW: 238, CW 138 - 12 pounds under goal!  


Virgie Tschirhart
on 11/6/17 7:54 pm - Midwest City, OK

That makes sense.


on 11/6/17 9:40 am - OK
RNY on 05/16/16

I am in Oklahoma as well!

No good advice except for what was already said. Call the number on the back of your card. I want to say that BCBS has to respond in like 15 business days with approval, but I'm not sure, and I have BCBS of Texas, so that might make a difference as well.

The customer service people are usually pretty good with answering questions though, they were very patient with me.

Good Luck!

Height 5'5" HW 260 SW 251 CW 137.2 (10/23/17)

RNY 5-16-16 Pre-Op 9lbs, M1-18.5lbs, M2-18.1lbs, M3-14.8lbs, M4-10.4lbs, M5-9.2lbs, M6-7lbs, M7-6.2lbs, M8-8.8lbs,M9-7.8lbs, M10-1 lb, M11-.6lbs, M12-4.4lbs

Virgie Tschirhart
on 11/6/17 7:57 pm - Midwest City, OK

Seems about right. The doctor's office told me they have around 21 days to answer. I just wanted to get an idea from you all.

on 11/6/17 11:26 am
RNY on 05/16/16

I didn't have a revision, but I have Federal BCBS and they gave me an answer in 7 days. They have fantastic customer service, just call and talk to someone.

49/F 4' 11" Highest Wt. 183.8--Surgery Wt. 173.0--Current Wt. 115.2--Goal Wt. 115.0

Virgie Tschirhart
on 11/6/17 7:58 pm - Midwest City, OK

That was quick 7 days. Thanks lykapal.

on 11/6/17 12:21 pm - baldwinsville, NY

I have BCBS anthem. I live in NY I think it only took 2 weeks and I had the revision from VSG to RNY

Virgie Tschirhart
on 11/6/17 7:59 pm - Midwest City, OK

Thanks for the info.