Recent Posts
Topic: RE: Getting Past Insurance Customer Service?
Do you mean the automated response (not a live person) that tells you to"press 1 to ...., press 2 to...? If so, then what I usually do (and it works for most any business you call that has an "automated response") is as soon as "it" starts talking, I start pressing "0" and I keep pressing it until it tells me it doesn't understand my response and to please hold while it transfers me to an operator. Once I get a real person to answer, I tell them to not put me on hold and to transfer me to another real person in the department I need. By that time I'm usually angry/frustrated enough to tell them how angry/frustrated I am and they don't give me any runaround or crap.
Beth

Beth
Topic: Getting Past Insurance Customer Service?
How do you get past the Customer Service "robot" that answers the phone? Is there a key person you ask for (nurse clinician, case worker, etc) or do you just ask for the "Supervisor"?
I have called regarding a specific question... And I can't get past the robot...
I have called regarding a specific question... And I can't get past the robot...
Topic: Too much weight loss during pre-surgery diet??
I have heard two different answers to this question- both from this board and both from my surgeon's office....
I am pre-surgery dieting and I am at the borderline of going under the required BMI of 40. I was well over it at my first appointment, but now I am getting close (within 2 pounds) and I still have 6 more weeks to go. (I have no other co-morbidities that would help qualify me.)
I have been told going under the 40 BMI is no problem but I have also been told you will be denied for this. Anyone have first hand knowledge of this situation. (BTW - I have Aetna.)
Thanks soo very much!!!
I am pre-surgery dieting and I am at the borderline of going under the required BMI of 40. I was well over it at my first appointment, but now I am getting close (within 2 pounds) and I still have 6 more weeks to go. (I have no other co-morbidities that would help qualify me.)
I have been told going under the 40 BMI is no problem but I have also been told you will be denied for this. Anyone have first hand knowledge of this situation. (BTW - I have Aetna.)
Thanks soo very much!!!
Topic: RE: Self Pay
Hi,
I was lucky enough to have the money to pay up front. Call Dr. Aceves number and ask for Nina, she is the patient coordinator and tell her Suzanne suggested you call her. She will work with you and answer all your questions as far as cost and a surgery date for you if you need. She may also know of places that finance this surgery--ask her she is a sweetheart.
I have never worked with a kinder, more helpful and caring group of people. I can tell you that you will NEVER receive better care in a fully equipped state of the are hospital that with Dr. Aceves and his staff. So many of these doctors that advertise on the Internet are not up to the high standards that you will receive from Dr. Aveves and his entire staff. And when it comes to your health you want a doctor that DOES have HIGH STANDARDS. Too many of them do WLS surgeries in a clinic and send you back to a hotel to recover and that is bad--and they will not tell you this before hand.
I HIGHLY recommend Dr. Aceves and his entire staff of talented and caring people. I would go back in a heart beat if I needed anything. And when you see Dr. Aceves please tell him that Suzanne says hi and that I sent you to him. Your only regret will be that you didn't do this sooner--that was my regret.
I am here for you or any questions that you may have about the surgery and the care--or anything you can think of. I know when I talked to Nina not long ago they had some specials that they were running for WLS so please call ASAP and tell her I suggested you call and talk to her--she is an amazing lady to work with. They are there for you every step of they way.
I read my Email daily so feel free to send any question that you have.
Hugs and take care,
I was lucky enough to have the money to pay up front. Call Dr. Aceves number and ask for Nina, she is the patient coordinator and tell her Suzanne suggested you call her. She will work with you and answer all your questions as far as cost and a surgery date for you if you need. She may also know of places that finance this surgery--ask her she is a sweetheart.
I have never worked with a kinder, more helpful and caring group of people. I can tell you that you will NEVER receive better care in a fully equipped state of the are hospital that with Dr. Aceves and his staff. So many of these doctors that advertise on the Internet are not up to the high standards that you will receive from Dr. Aveves and his entire staff. And when it comes to your health you want a doctor that DOES have HIGH STANDARDS. Too many of them do WLS surgeries in a clinic and send you back to a hotel to recover and that is bad--and they will not tell you this before hand.
I HIGHLY recommend Dr. Aceves and his entire staff of talented and caring people. I would go back in a heart beat if I needed anything. And when you see Dr. Aceves please tell him that Suzanne says hi and that I sent you to him. Your only regret will be that you didn't do this sooner--that was my regret.
I am here for you or any questions that you may have about the surgery and the care--or anything you can think of. I know when I talked to Nina not long ago they had some specials that they were running for WLS so please call ASAP and tell her I suggested you call and talk to her--she is an amazing lady to work with. They are there for you every step of they way.
I read my Email daily so feel free to send any question that you have.
Hugs and take care,
Suzanne B
Eugene, OR
Dr. Aceves
10/21/2008
Start lbs 225
Now 120
Eugene, OR
Dr. Aceves
10/21/2008
Start lbs 225
Now 120
Topic: RE: Self Pay
Hello Suzanne,
I see that you had your surgery with Dr. Aceves in Mx. How was your experience? I am really considering it, but i keep getting the run around about the cost. Did you happen to go through beliteweight, or did you pay upfront?
I see that you had your surgery with Dr. Aceves in Mx. How was your experience? I am really considering it, but i keep getting the run around about the cost. Did you happen to go through beliteweight, or did you pay upfront?
Topic: RE: Independence BCBS Approval Question
Usually they should have a section about pre-authorization for hospitalizations... some require a phone call some require a letter... but I think just about all of them require some sort of notification at least even if they don't need to authorize the charges. Not sure if you have access to your plan rules and policies online like I do. When I called to get my ultimate denial for the process, I was at least armed with all of the "standard" info so I felt a litter better about the idea of having to jump through hoops with someone on the phone just to get an answer. My parents are BCBS people though and their process is sooooooo streamlined that it's incredible. So hopefully you've got everything you need.
Topic: Independence BCBS Approval Question
Hi everyone! So, my surgery is in 8 days, and as I'm looking around the site, I am noticing that there are lots of people who had to get Insurance Approval Letters and stuff........My question is this:
When I was scheduled for my surgery date, no one in the office mentioned anything to me about insurance. I got my date the same day I had my second consult. I am going to call tomorrow and make sure my insurance is all okay, but, I'm curious to all the BCBS'ers, did you guys need to wait for a letter? or did it just happen like mine?
My mom said that when she had hers (7 years ago) she didn't have to wait for a letter either...and she also mentioned that if there was a problem or if insurance wasn't covering it, they would have asked me how I was financing the procedure when they gave me the date....
I already have enough on my plate to stress out over, so, this is NOT something I'd like to add to it. anyone have any input on the matter?
Thanks!
When I was scheduled for my surgery date, no one in the office mentioned anything to me about insurance. I got my date the same day I had my second consult. I am going to call tomorrow and make sure my insurance is all okay, but, I'm curious to all the BCBS'ers, did you guys need to wait for a letter? or did it just happen like mine?
My mom said that when she had hers (7 years ago) she didn't have to wait for a letter either...and she also mentioned that if there was a problem or if insurance wasn't covering it, they would have asked me how I was financing the procedure when they gave me the date....
I already have enough on my plate to stress out over, so, this is NOT something I'd like to add to it. anyone have any input on the matter?
Thanks!
Topic: RE: Anthem BCBS of CA... 6 month supervised dietary program question
I have BCBS as well, and no one mentioned to me anything about a 6 month medical diet and my surgery is in 8 days, so, I think you're okay!
Topic: fed blue cross blue shield
my only concern is:the evidance of weight loss in the year prior being ineffective part... I have dieted and tried but on my own.. I keep meeting that brick wall..lol... So how do I prove it if I have been doing it on my own?
I do My consult with surgeon this week...Have started my 3 month with my pcp.... )
FEP 2011 Definition of Morbid Obesity:
A condition in which an individual has a Body Mass Index (BMI) of 40 or more, or an individual with a BMI of 35 or more with co-morbidities who has failed conservative treatment; eligible members must be age 18 or over.
Benefits for the surgical treatment of morbid obesity, performed on an inpatient or outpatient basis, are subject to the following pre-surgical requirements.
The following requirements apply to gastric restrictive procedures, gastric malabsorptive procedures, and combination restrictive and malabsorptive procedures to treat morbid obesity:
- Diagnosis of morbid obesity for a period of 2 years prior to surgery.
- Participation in a medically supervised weight loss program, including nutritional counseling, for at least 3 months prior to the date of surgery.
- Pre-operative nutritional assessment and nutritional counseling about pre- and post-operative nutrition, eating, and exercise.
- Evidence that attempts at weight loss in the 1 year period prior to surgery have been ineffective.
- Psychological assessment of the member's ability to understand and adhere to the pre- and post-operative program, performed by a psychiatrist, clinical psychologist, psychiatric social worker, or psychiatric nurse.
- Patient has not smoked in the 6 months prior to surgery.
- Patient has not been treated for substance abuse for 1 year prior to surgery.
my only concern is:the evidance of weight loss in the year prior being ineffective part... I have dieted and tried but on my own.. I keep meeting that brick wall..lol... So how do I prove it if I have been doing it on my own?
I do My consult with surgeon this week...Have started my 3 month with my pcp.... )



