BCBS Policy Change

I know that they changed to 6 months "conceutive" weight loss program but has anyone heard of being "grandfathered" in. I'm in my sixth month but i had missed one month in the middle and dont feel like I should have to wait another 4 months just because the changed their policy on me half way though.

Sorry I had to vent,

Dave

Dave - that really sucks!  I know that PNC told me consequtive months from the get go even though BCBS told me they didn't have to be consequtive and I didn't even need 6 visits - just beginning, middle, end.  Well, I went by PNC's suggestions and did 6 consequtive.  You can't trust those sneaky insurance companies!

I would call BCBS and ask - I wouldn't be surprised if they didn't grandfather, but you never know.  You could try submitting and then do an appeal.

good luck
Amelia

I don't have BCBS but I had to do three months of 'consecutive'... so I did 3 appts (one a month) and thought I was good to go. Well then the clinic tells me that three consecutive months = 4 appts.... wuh??

Well, anyway... by the time I could get a 4th appt scheduled, it was not considered 'consecutive' anymore and I was worried that it wouldn't count.... but all in all, things went through OK... so I suspect you may be OK. Talk to your clinic and insurance company.

I have BCBSMN and called them when I found out about the change.  The new policy went into effect February 16th.  It states "six consecutive visits".. I called Blue Cross and they confirmed that it was no longer six MONTHS of consecutive visits - so start to finish 6 consecutive visits.

I would call Blue Cross to clarify - your surgeons coordinator should be able to call and get that information for you as well.

Best of luck!

Okay I know that I am late responding to this. I am confused. My surgery was just denied a fews weeks ago by BCBS because they said that even though I went to 6 consecutive appointments in six consectutivemonths (1 in Oct, Nov, Dec, Jan, Feb, and march) that it was not six months from the first appointment to the last. I think I was 10 days short.
Sharin

i think an appeal would work for you ... i know that is what i'm planning on doing.

I know I was 3 days short and the insurance lady at PNC basically told her that if I was denied over 3 days she would be really pissed.  Must have worked because I got approved that day.

Besides, the new policy says "six monthly medical visits over six consequetive months".  I doesn't say 6 month duration anymore, so the 10 days shouldn't matter.  Did  you get denied before the new policy was in effect?