Anthem BC/BS Approval?

Dalene · 06-29-2008, 09:06 AM

I have a surgery date for July 28th. Documentation was submitted to insurance company ( Anthem BC/BS ) on June 26th. Doctors office said we should here by this week. Does anyone else have Anthem, and how long did it take to get approval? Very anxious! Whole process was fairly quick. Consult 5/14/08, completed all required testing, Pre-op appointment 6/26/08 with submission of documentation to insurance. Liquid diet starts 7/14/08.

marinemom · 06-29-2008, 11:34 AM

Hi, Dalene-
I have Anthem BC/BS and received my approval May 19th and my surgery was June 4th - just enough time to get my liquid diet in before surgery! My BMI was 37 but I had some co-morbidity factors.
All the best to you!

sharona · 06-29-2008, 01:38 PM

HI Dalene

You shouldn't have a problem with BC Anthem, I also have them. Although it may be different from state to state I haven't sen anyone on this blog who was refused with blue cross.....unless you have an exclusion. If you called them prior to going to physician's office they would have told you that you had the exclusion....good luck and welcome to our world.

mike1019 · 07-01-2008, 09:30 AM

Hi! I also have Anthem BCBS and was wondering what documentation you had to provide? I have BMI of 39 with Type 2 diabetes so I'm pretty sure I shouldn't have any problems but would just like as much info before I pursue it. Thanks!!

Dalene · 07-01-2008, 12:51 PM

Hi Mike, I had the following test. Blood work, Nutritionist, Psychiatric clearance, Cardiac clearance (EKG) & Echocardiogram, Upper GI, Pulmonary Function Test, Arterial Blood Gas Analysis. I do not have any other health issues other than having a BMI of 43. Hope this helps.

poohprecious · 07-01-2008, 07:14 PM

Quote:

Originally Posted by mike1019

Hi! I also have Anthem BCBS and was wondering what documentation you had to provide? I have BMI of 39 with Type 2 diabetes so I'm pretty sure I shouldn't have any problems but would just like as much info before I pursue it. Thanks!!

Hi Mike I have Anthem BCBS and I was approved yesterday and all we submitted was letter of medical necessity,lab work, Psych and Nutritional Evaluations, BMI, and non-surgical weight reduction documented attempts (i used WW, nutrisystem, etc)..........hope this helps!

BTW it took only two days for my approval :) Anthem BCBS is the best by far!!

mike1019 · 07-02-2008, 02:13 PM

Thanks!! I was really excited after reading this thread but then I talked to Anthem today and my group policy has an exclusion

. Needless to say I am very disappointed. I even asked about medically neccessity and nope, nothing! I have type 2 diabtes, high Cholesterol and high triglycerides with a BMI of 39. Looks like it'll be back to Weight Watchers

ellendeette · 07-02-2008, 02:20 PM

I have Anthem Blue Cross and was approved the following week after the psychologist submitted her report of our meeting. I had three months from the date of approval to have my surgery. Blue Cross called me and assigned someone to me to answer any questions about the surgery and after the surgery. They have called several times to see how I was doing. I was quite amazed. They never did they before with my other surgeries (knee surgeries and cataract). Good luck to you! I hope you are approved soon and you will be on your way!

jillissac · 07-14-2008, 04:04 AM

Hi. Just curious...My BMI is <40 also (with Anthem BCBS). Wondering what comorbs you had to get approved. My PCP is all for the surgery and wants to help all he can. I have issues but not severe (yet).

poohprecious · 07-14-2008, 06:48 AM

Quote:

Originally Posted by jillissac

Hi. Just curious...My BMI is <40 also (with Anthem BCBS). Wondering what comorbs you had to get approved. My PCP is all for the surgery and wants to help all he can. I have issues but not severe (yet).

Sleep apena, hypertension,diabetes will get you approved for sure........not sure about anything else my BMI was 41 so I lucked out in a sense.............

sharona · 07-14-2008, 11:37 AM

Quote:

Originally Posted by jillissac

Hi. Just curious...My BMI is <40 also (with Anthem BCBS). Wondering what comorbs you had to get approved. My PCP is all for the surgery and wants to help all he can. I have issues but not severe (yet).

Hi Jill

My BMI was 43 and I had osteoarthritis and sleep apnea. BC is very good about their standards. They criteris is 40 BMI with some issues (like HTN/diabetes/sleepapnea/arthritis) or 35 BMI with more serious issues.

If your over 50 you probably have osteoarthritis as most people do and my guess is you also have sleep apnea which your surgeon should be sending you for a sleep study.

good luck

sharon;)