Do you have Blue Shield of CA???

I have one more appointment this Wednesday (hooray) to finish up my pre-op testing.  Then, it's off to insurance for approval.  I was wondering if anyone here had Blue Shield of CA.  Ours is the Access plan with no medical group.

If so, how did the process go?  I'm keeping my fingers crossed that this goes smooth.  I hope they don't come back with a denial or a 6 month diet requirement.

Thanks for your time.
Danielle

I have Blue Shield with the Access Plus Option. I do have a group and they wanted the 6 months of nutritional counseling.  See my blog from April.  I also have a copy of the letter on the top of my blog that documented "my issues."  It helped my primary doctor and the surgeon when they asked BS for approval. Feel free to copy it and tweak it to fit you. I would give a copy of it to your doctor on Wednesday so they have it when they create your "medical necessity."  I had approval in 3 days once they had this letter and my preop tests.

Thank you!  I just copied and pasted in Word.  My insurance is a direct contract with Blue Shield.  I am not assigned to a medical group.  I've called and asked if they require a 6 month MD supervised program first, and they said no.  Just psych, nutritionist, and 40+bmi.  I've done all of that and more.  Gosh, I hope this goes smooth.  I've got your letter saved just in case I need to get serious with em'.  Thanks again for your response!

Hi, I also have Blue Shield, and no problem with the authorization,
my doctors office submitted it on Nov 4th and I got the call on the
6th that it was approved and had my surgery on the 20th.

Good Luck

Judy

WOOHOO!!!!!!!  Thanks for your response.  I can't wait.

 Good luck with your insurance, I hope you get an approval. If they deny based on the 6 month supervised diet go to the link in my signature. There is a link in there from the DMHC's (dept of managed health care) peer review article stating that the 6 month supervised diet is not necessary and that there are no published studies that support requiring a patient to do any supervised diet once they are deemed a candidate for WLS. You should be fine as long as you have a BMI 35 > with comorbidities or BMI 40 w/o. Best of luck

Thank you!  I copied and pasted to keep in case I need it.  I'm so glad I stopped by the CA forum.  I normally just keep to the main board but this has helped so much.  Thanks everyone.

Good to know! I would definitely add that to the letter!

Me too, BS PPO got approval for my DS in 2 days!  Good Luck

Yes!  I'm getting so excited now.  I told myself 2009 is going to be my year.  I'm going to take care of myself.  Even if by some freak chance, I don't get approved.  It's time to get healthy.

Thanks, everyone.