Recent Posts

sheshemaclin
on 1/26/13 1:55 am - IN
Topic: highmark bcbs insurance

does anyone here have bcbs highmark and had the gastric sleeve done? i know they cover the rny and lap band but not sure about the sleeve. cant find my benefits booklet and they dont have one online. thanks

sarapilar
on 1/24/13 10:15 am
VSG on 02/21/13
Topic: How long does it take to hear back from United Healthcare?

My surgeon's office submitted my paperwork yesterday.  I called today and they confirmed it is in process, in review.  How long does it take United Healthcare to get back to people on the approval?

"The most difficult part of changing how you live and eat is believing that change is possible. It takes a fierce kind of love for yourself."Geneen Roth
    
noonietunes
on 1/24/13 9:24 am
RNY on 01/29/13
Topic: RE: FEPBLUE approved!

8 calendar days.  My surgical coordinator called them daily.  It takes a day for the faxed information to be logged and get to the nurse.  In my case, the nurse then had it for 4 business days for some reason, and then it was referred to physician review.  The physician signed off on it within 2 hours of picking it up the next day.  My case was flagged for physician review because it's the RNY, and my BMI is between 35 and 40 with comorbidities.

VSG on 06/12/13
Topic: RE: United Healthcare
I am living it right now. Two denials citing not being at 40 now and also for the past 5 years (nevermind I was working with my doc, ugh!) my insurance coordinator basically gave up on me today. I am going to be working with Walter Lindstrom on appealing it right up the ladder.

I hope you had better luck than I, but based on my experience, it'll be a tough road.

   

Sleeved 6/12/13 - 100 pounds lost to get to goal!

Djj1222
on 1/23/13 6:05 am
Topic: RE: FEPBLUE approved!

Good Job.

My info was sent up to them (FEPBLUE) today.  How long did you have to wait to hear approval?

noonietunes
on 1/23/13 2:09 am
RNY on 01/29/13
Topic: RE: FEPBLUE approved!

Yes, yes it is! The wait was making me crazy!

 

Tamiasmom
on 1/22/13 3:34 pm - Chicago , IL
Topic: Medicaid Approval in Illinois
Has anyone used Medicare insurance in Illinois? If so was the process long for approval? Did anyone use UIC for their WLS? I Ned help.
noftessa0401
on 1/22/13 12:46 pm - San Diego, CA
RNY on 12/27/12
Topic: RE: FEPBLUE approved!
Congrats! It's a great feeling, ain't it?

HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"

M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)

noonietunes
on 1/22/13 3:48 am
RNY on 01/29/13
Topic: FEPBLUE approved!

I'm APPROVED!  

First submission with BCBS Federal.   BMI > 35 with hypertension, mild apnea and a host of other comorbids that aren't in the bariatric trinity (Diabetes,hypertension,apnea).

I just want to say.. UP YOURS NALC!!!! (they denied me last year, would not forward my file to Cigna,  and would not look at my clnicals  quote on the phone.. .. "you're just taking blood pressure medicine").  I did get a sleep study after their denial to confirm mild apnea as NALC complained ... "you just have snoring.."

My advice to federal employees seeking this surgery with a BMI < 40.. stay away from FEHB insurance plans that have a middleman between the company and their underwriting insurance.. you will only wind up with two layers of bureaucracy to slog through to get approved.

(deactivated member)
on 1/18/13 2:17 am
Topic: RE: Looking for a Dr.

I understand wanting the BLIS but a COE doesn't mean the surgeon is good.  It really means they have a policy and procedure manual with all the right words in there.  Some of the biggest bariaric butchers are COEs.  Some of the best surgeons are not.

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