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Post by tafica on Mar 17, 2014 9:13:11 GMT -5
I am still in the early process of getting the DS. I haven't even met with my surgeon yet but it's in the works. I have so many questions, but I will start with questions about insurance. Does any one have Blue Care Network and what was your experience with them? My BMI is only 39 but I have high blood pressure among other things. Anyway, I just recently switched to Blue Care Network but I have already done the diet monitored by my Primary Care Dr, but I am still nervous if they will approve me. The thing is when my Dr put me on the diet it was more to help with my blood pressure not really with the intent of having Weight Loss Surgery so I am not sure if it will meet Blue Care Networks requirements. My Dr is fully supportive of me getting the DS and actually has a Medical Assistant on his staff that got it done 2 years ago and she has offered to help with the paper work. I'm wondering if my food log's form My Fitness Pal would be helpful for the insurance company? should I print those out and give them to my Dr to add to my chart? Any info or help with insurance would be great. Thanks
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Post by teachermomolp on Mar 17, 2014 10:41:18 GMT -5
Hi there. I never heard of Blue Care Network, but I've been through the wringer with insurance companies. Your surgeon's patient advocate will be able to help with all of this insurance business. Your policy may be different from another person's Clue Care Network, so you really need specific info about what your policy requires. Also, my surgeon had his own separate requirements that differed from my insurance's so you really need to get that relationship in motion ASAP. Specifically, I had to lose a certain amount of weight pre-operatively- usually that's an insurance req- this time it was the doc's. I did use My Fitness Pal forms in my appeals and it didn't seem to help my case. But your case is different from mine. If you get denied, you will have an opportunity to appeal- just let the doc's specialists do the first round. They know what they are doing. Good luck!
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Post by goodkel on Apr 12, 2014 3:08:02 GMT -5
Get a copy of your complete insurance policy. As teachermom mentioned, every policy is different. Two people using the same company can have completely different policies. It should tell you what is covered and their requirements.
Your surgeon will submit you for approval, but it is better if you know and have completed any pre-operative hurdles that they require.
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