BMI 39-bcbs of north carolina

Thread Starter

I would continue to go forward with it. Just as Flipp said, she works for BCBS and they do not require you to pay the deductible upfront. It is totally up to the hospital, some will try and make you pay up front, hopefully mine will not. I'm going to move forward and pray for the best. I would listen to Flipp though as she works for BCBS.

The Rex's deductible can be billed. I just had all my bills (deductibles) set up on payments...hospital (Rex) and the
Anesthesiologist. Now the doctor's office is another thing. I had to pay my surgeon's deductible up front. Be specific. Is it the surgeon's office that requires their deductible up front or the other areas (Rex, anethesiologist, lab work, Xrays, etc.)?

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Life is Beautiful,
Sterlingstar1

Thread Starter

The hospital where they will be doing the surgery (Duke). I'm not referring to the co-pays. How much was your deductible prior to surgery? And this info that you don't have to pay your deductible upfront came from someone that works for BCBS of NC.

It is my deductible for the year for my insurance. I know that I have a co-pay of 250 for the hospital. Our deductible just started for the year. This is just confusing to me. Every year you have a deductible for the year I got that much but if she is saying that I have to meet that first that does not make sense because I have till july of 2010 to meet that.

Whenever you have services performed at the hospital your deductible and co-insurance will apply. Example: Claim for pre-op testing at the hospital $1000, if you have not met your ded when the claim processes 600 will automatically be applied to your ded(1000-600=400) Of that 400 that's left you will be responsible for your co insurance precentage which varies depending on what plan you are on. After that percentage is applied to your coinsurance then whatever is left over insurance will pay to the provider. Since 600 went to your ded and a percentage went to your co insurance the provider is going to bill you for those amounts. So yes your ded applies to the entire benefit period, but it has to be met before the insurance will pay anything. Your ded does not apply to office visits or simple lab work and that's why the insurance pays those claims when you haven't met your ded. Let me know if you have any other questions, insurance can be confusing

Thank you for the information, in speaking with a bcbs rep this morning I did find out that before the surgery I would have to pay this $600.00. After this is paid the claim for my surgery will be paid. Until the deductible is paid no surgery. It does not matter nothing is going to stop my progress. I am still moving forward with the surgery. Thank all of you for answering seemed like to me a crazy question.

Flipp,
I finally got, yesterday was a eventful day and I had four appointments that I finally finished. In the am I had a barium test next I had a chest xray, went down to have labs and finally ekg. This process is full of appointments and some times disappointments but I have one last appointment and then the rest of the waiting begins. Next week I will have one appointment and that is with the cardiologists to be released for surgery. The excitement is building as these appointments are being completed. Hopefully I can be banded next month. I am not clear as how i will be able to come up with the money but it will be well worth it.

There is so much that you have to do before you get to your surgery day, but once you get there it's worth it. You're almost done, once you've completed all of the tests and have your bmi history it should take less than three days for the approval from insurance. As far as the money goes tell them to bill you and then set up a payment plan. Let go and let God I hope you get the date you want!!!!
I'm only three weeks post op and I can already see the difference in my clothes and I haven't had a fill yet. I have my first fill in August and I can't wait.

My weight history was completed when I first submitted my paper work to the office. I am so excited to know that it is almost over. This thursday I will be finished with my cardiologist. I know it will probably be a week before I here anything fromt he doctors office. I was hoping for mid August maybe there is a way. Keep me in your prayers.

Hang in there, the date will come sooner than you think.

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Initial Consult 5/12/09 Barium Swallow 5/15/09
Pshy Evual. 5/20/09 Sleep Study 5/21/09
#1 Nutrition Evual. 5/21/09
#2 Nutrition Evual. 6/25/09 #2 Consult 6/24/09
Approved 7/1/09 Surgery Date 7/31/09


Nothing tastes as good as being thin feels.

Do you know how much weight you lost?

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Initial Consult 5/12/09 Barium Swallow 5/15/09
Pshy Evual. 5/20/09 Sleep Study 5/21/09
#1 Nutrition Evual. 5/21/09
#2 Nutrition Evual. 6/25/09 #2 Consult 6/24/09
Approved 7/1/09 Surgery Date 7/31/09


Nothing tastes as good as being thin feels.

I have finally completed all of my test and would like to know what do I have to do next. My stress test lasted from 9:00am till 2:45pm. It was a long day and I am so glad that part is over. I guess it is a wait and see process.The excitement is still there and I am waiting for the call.

Thread Starter

Update! I finally got a call on yesterday, my surgery date has been scheduled for 08/13 (YEA!!!!) Don't know how to post a smiley face. They said that the only way my date will change if my insurance doesn't come back approved in time, but they don't see why it wouldn't they have everything they need (YES). I'm finally excited, keep me in your prayers.

We must be doing something right, I got a call yesterday and my surgery date is 08/13 also (yes!!!!!) Same hear as long s the insurance comes back. I am so excited until I could burst at the seams. Where are you being banded, well I will be at Rex, maybe we can call each other after the surgery.

Thread Starter

I'm being banded at Duke, and yes we should call each other afterwards and maybe the night before to see how calm we are (smile). Seems like things are picking up for us.