California Blue Shield HMO

Hello Everyone,

I was wondering if there is anyone out there that has Blue Shield of CA, and how long did it take for them to approve your surgery? Please advise? I just switched to thise insurance and am wondering how long it takes to get approved.


Thank you all in adance!

Call the insurance and see if you can speak with the pre-cert dept. If they wont ask you then ask the customer service rep. Once my insurance turned in my paperwork I was approved the same day even though they could have taken up to three days to approve. I did not have to do a 6 month diet or anything. My records just had to show that sometime over the last twelve months that I met with my PCP about diet and exercise three times.

Hello Brenda,

I am actually working with the weight loss surgery center already to have my surgery just have to ofcourse do it all in steps so i was just wondering if anyone has had the same coverage as me and how long it took them to authorize and okay to do the next step...im just very impatient which is NOT a good thing...thank you all for your help :)

On January 5, 2012 at 1:18 PM Pacific Time, bdocker wrote:I have Blue Sheild of CA but its PPO not HMO. Calling customer service takes a LONG time because all they want to tell you is that bariatric surgery is a covered benefit not what the requirements are. So if you can stop them from telling you what is covered and coerce them into telling you the requirement that is what you need to do.

Mine has a six month supervised weight loss but they are VERY open about any method of weight loss as long as it's supervised and you can provide records.

Brenda~

Brenda...agreed on customer reps...can call em 10 different times n gettin 10 different answers...me 3 TIMES before I got someone that gave a **** about me! I stuck with her throughout...including DENIAL
(back in them VSG pioneerin days) TO WINNING ON APPEAL...she was a blessin that gal...

BCBS of Cali...DOES NOT REQUIRE medically supervised weight loss inc. ALL PPO insurance cos...HMOs like KAISER....you can get even THEIR medically supervised Optifast m.s. diets WAIVED!!.... ...THE WHOLE STATE

its been found to be a WASTE OF TIME and MONEY....California Dept of Managed Health Care
and California Insurance Commision

SAYS SO!!

http://www.dmhc.ca.gov/aboutTheDMHC/org/boards/cap/Bariatric REV.pdf

KNOW yer policy! I have BCBS Cali...PPO!! never did ONE DAY of WL diet...That WAS over 3 yrs AGO!!