Question:
What requirements do HMOBlue of New York require?

Does anyone have Hmo Blue of Utica/Watertown(NY)?Can somebody tell me what their requirements are for WLS?I hear that the doc can submit your highest weight to get approval,how does this work,do they use a form letter?Does the doc use your highest weight as your current weight?    — natalie J. (posted on August 6, 2003)

August 6, 2003
Hi Natalie! I work in a doctors office that does RNY. If go to this website http://www.excellus.com/medpol/surgmgmtobes03.pdf ( you'll need to have adobe to view the file) but this will give you the medical policy for Gastric Bypass. I see that your BMI is 35, you may run into some problems. BCBS requires 40 or higher unless you have co-morbidities. The doctor has to send in all of his documentaion. They shouldn't submit your highest weight as your current weight. Doctors offices can get in a LOT of trouble if they "fudge" the truth. If I can help any more let me know! Good Luck!
   — Ashley S.