If you've read my previous post here in the Insurance Forum, you will know that I'm very frustrated with the approval process with my insurance company.  First of all, it is VERY difficult to get someone at the insurance company to return a call (the approval process for bariatric surgery goes through a special department where no one actually answers the phone - everything is done by voicemail).  For over four weeks now I have been receiving conflicting information from the insurance company and the surgeon's office.  When I do get a response from the insurance company it is always "we haven't received anything, have your surgeon fax us at.....".  When I talk to the surgeon's office I am told "we submitted everything several weeks ago and have followed up and they have it.  It is pending and being reviewed.  They have 90 days to respond and they will not acknowledge receipt due to liability issues"  It has been over 4 weeks.  I was given the impression that my insurance was one that responded very quickly with approvals/denials (per the nurse in the surgeon's office).  So, who am I supposed to believe??  Someone is obviously giving me bad information or lying.  I am about ready to just forget having surgery.  The whole process from getting my psych eval received at the surgeon's office to scheduling a sleep study has been a nightmare and very stressful.  I really just don't see the point in planning on surgery anymore....

Hi, I also have Highmark and if I were you I would request a copy of your bariatric portion on your policy.  Specifically the weight loss section.  You may even be able to view it online.  I think the website is www.highmarkbcbs.com

I have BC/BS and I felt that way also when I first visited my PCP.  My surgeon's office provided me with a form that my PCP would complete on each visit.  I think they took the one from Cigna as a matter of fact and retyped it for general use for all patients to have.  Now, for me, I had to work with the surgeon's nutritionist and my PCP both.  My PCP's notes were very vague-kind of like what you had stated....three meals a day, exercise three times a week, etc.  He never wrote anything down specifically, like eat 1,500 calories a day, etc.  I am pretty sure the nutritionists notes were more in depth. My PCP did write down any changes I would have personally within the last month in my notes.  For example, I pulled a muscle in my back and he would write-exercise limited to a total of 4 times a month due to back injury, etc.  Hope this helps!

Hmmm, that is so weird.  Do you have BC/BS?  I can view my policy online.  Can you do that?  I wonder if you contacted your HR Dept. at work if they can send you the full written portion of your policy, (just the weight loss portion)?  Let me know if you find something out, can you?  I am very confused on who to believe.  Since my posting I have contacted the insurance rep. that works for the surgeon so she can check.  Sometimes they know how to word things to your insurance company.  That may be a good idea too.

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The conference for this year will be held in Los Angeles, California on August 15-16, 2014.

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