Question:
Anyone had any experience with Blue Cross Ca PPO?

I am trying to get this surgery for the second time. year was unsuccessful with insurance, and I didn't realize I could appeal! I am now insured with Blue Cross of Ca, PPO, and I am just wondering if anyone found it difficult to get approval, how they got around the denials, etc. My appointment is March 9th, and I just want to line up my ducks! Any help would be appreciated! thanks! Elise~    — Elise D. (posted on June 3, 2002)

June 3, 2002
I have Blue Cross PPO.. I was approved for WLS in 3 days and a Tummy tuck in 3 days you said blue cross then had BC/BS Blue shield is harder to get approved.. where in CA are you I have the most fantastic Doctor Doctor Paul Frye Allied Surgical Group Fresno, CA 559-449-4030 they do surgery at Fresno Surgery Center.. it is so awesome there a family member is welcome to stay all rooms are private.. so elite... no tubes when you awake nursing staff is 1 nurse to every 3 patients.. Doctor Frye follows you as a patient for a min 5 yrs he says your stomach is his forever... he is wonderful I will sing his praises to the highest he isn't only a fat Doctor he is a surgeon he will take care of other problems while he is in there he does Open or Lap mainly Lap his after care and diet are reasonable Please anyone in California.. Trust me on this Doctor so many of Us in Salinas have used Frye.. any questions concerning this give me a call Kathy McAlister 831-759-9936
   — Kathleen M.

June 3, 2002
Hi Elise- I am a "lightweight" with a BMI of 36 and severe co-morbidities. Most people report that Blue Cross of CA (PPO) is very easy to get approved. I believe that to be true if your BMI is over 40. If it is under 40 you need to substantiate that you have "life threatening" co-morbities. So I had to substantiate my case which obviously included my surgeons information but also my own letter articulating my severe co-morbidities. I was confused by your bio and question in that you have already had surgery it looks like last year? If I can be of an additional help, please contact me.
   — Joanie J.

June 3, 2002
Dear Elise, I have Blue Cross PPO. After my intial appointment with the surgeon, Dr. Waldrep in Roseville, CA. Immedently after I left they were on the phone with blue cross and got me approved right over the phone pretty painless. I hope you have the same luck. Cristin
   — Cristin C.

June 7, 2002
Elise, I used Blue Cross' Prudent Buyer/California Care PPO for my RNY, and was approved the first time around. My surgeon, Dr. Philippe Quilici of Burbank who has surgical privledges at Cedars-Sinai in Los Angeles, said that with most insurance companies he and the staff had dealt with, they were having to go to first appeal to get the procedures covered. I know of another woman with the same insurance who also had here surgery performed by Dr. Quilici, and she also was approved the first time around. All the best to you.
   — CaseyinLA

May 26, 2006
I have bc/bs of CA PPO i got aproved with the first letter sent to them by my doctor. Very happy with Bc/Bs...good luck to you!
   — LBair

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