Question on BCBS MN

glitterchick
on 11/12/07 2:00 pm - Savage, MN
Hi all!   I was wondering if anyone here could help me out and tell me anything now ahead of time that I need to know to make sure that im not denied by BCBS MN? I went to the BCBS website and looked at the medical policy. As of what they have posted I will have met all the requirements after my 6 month diet thing is done. PNC/Methodist does a great job and they even gave me a checklist. Dave the nurse said I should be fine. But I have been reading the insurance boards and they have got me nervous. I would hate to be going through all these things I need to do to have them say...Nope. Sorry. Have a nice day. I was just wondering if anyone had any problems with BCBS MN and what I could do now to make sure that in 6 months im free and clear :) Any advice would be helpful!! Thanks guys!
kim J.
on 11/12/07 9:09 pm - knoxville, TN
Glitterchick  congratulations on your decision to start your journey.  I dont know much about BCBS in particular since there are so many different plans available. however, with most insurances that require the pre weight loss, documentation seems to be the key.  Document at least weekly, along with your doctors documentation.  Keep a daily food journal, daily exercise done, dates of doctors visit, and at least weekly weight.  does your insurance require your 6 month wt loss be physician directed??  If so, dont miss any doctor appointments associated with this, because some bcbs plans make you start over at month 1 if you miss even 1 appt.  I know this sounds like a lot, but it is worth it in the end when your approved, and have your surgery without any delays.  Also, it helps you be better prepared for your life style changes after surgery.  Good luck to you on your journey!!

Tammy A.
on 11/12/07 10:40 pm - Maple Grove, MN

Hi,

First of all good luck on your journey and congrats on the great decision to help yourself get healthy.  I had BCBS of MN, but all policies are different.  I actually called the help line and asked the questions to them directly to be sure I was clear on what needed to be done.   I went through the Unity Hospital program and to my surprise I got through the process in 4 months.  They approved me in about 2 days after submitting.  I had previous documentation the trying to loose weight for 2 years so that helped I think.   It was fairly easy with them and they covered all but 2500 of my bill.  Good Luck. Tammy



 

Heather L.
on 11/12/07 11:46 pm - St. Paul, MN
I have BCBS MN and went through PNC... Had NO problems...Was approved in about a week. I would make sure that Bariatric Surgery is not specifically excluded by your employer,  but if it isn't you shouldn't have any problems at all! Good luck!
Sandra N.
on 11/13/07 4:18 am - MN
I had BCBS of MN also.  I just called them up(per my bariatric clinics request) and asked all the requirements for WLS and what they covered and their requirements.  I did what was required and met all the requirements and boom I was approved. So my best advice is call them and do what they say and it'll go well!  Congrats on starting your journey!

 ~Sandie~ -147!!WLS:12-12-06:Preop 268,Ht.5'4",BMI 44.9
  Click on link to see my journey!!! 
http://www.onetruemedia.com/my_shared?z=2bfaca5561a1d558fceb
87&utm_source=otm&utm_medium=text_url

"Do unto others as you'd have done to you"~ The Golden Rule to Live by!
You are what you EAT and WHO you hang out with!  Choices=Outcome~ what's YOUR choice??
I'm not perfect but I am going to die trying!!!

 
  



HappyYap123
on 11/13/07 9:47 am - Rush City, MN
My thoughts echo Sandies as hers is similar to my experience. Keep the name & phone # of whoever is working on your case for approval & anyone else that's helpful along the way at BCBS. Keep regular contact with them and - most important - remember that a denial is not the end of the road. Both my husband and I were denied and then approved - it's a bit of a game and just stay on top of whatever it is that they used as the excuse for denial (usually more info). They're very helpful when you ask questions and stay on top of it though - be polite and respectful with them and they'll help you out.
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