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04-19-2008, 01:32 AM
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#1 | | Registered User Thread Starter  
Join Date: Apr 2008 Age: 25
Posts: 142
State: louisiana | HELP BCBS of MN 6 month diet
I have bcbs of mn they said they cover Lap Band but I need the 6 month diet. So I am doing it with my reg. dr because she is in my town. My bariatric center is almost 2 hrs away so I am not using there nutritionist. So I am on my 4th month of the diet and my patient advocate is saying that my dr is not taking the notes right and I should drive to see the nutritionist also for 6 months. Even the nutritionist says thats ridiculous. So this is what I am getting to I am so worried that by only seeing my reg dr for the diet that I wont get approved. But I am doing what the insurance asked the 6 month diet. Does anyone have experience with bcbs of mn? I am so excited about this surgery and so worried they will deny me. I guess I just need to hear some experience from others with my insurance :) Help ease my mind pls
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04-19-2008, 01:30 PM
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#2 | | Ldsjen0227
Join Date: Apr 2008
Posts: 2
City: Belleville State: MI |
I have am working with blue care network of MI, and they are basically the same, and even though I had 2 years with my doctors office I was denied because I didnt have 6 months with a nutritionist. Ridiculous I know, but I should know with in 4 more business days if going to the nutritionist did it.
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04-19-2008, 02:43 PM
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#3 | | Registered User Thread Starter  
Join Date: Apr 2008 Age: 25
Posts: 142
State: louisiana | Quote:
Originally Posted by ldsjen0227 I have am working with blue care network of MI, and they are basically the same, and even though I had 2 years with my doctors office I was denied because I didnt have 6 months with a nutritionist. Ridiculous I know, but I should know with in 4 more business days if going to the nutritionist did it. |
hmm well this is the thing my policy ask for a medically supervised diet for 6 months.. Im doing that its the patient advocate who wants me to do the nutristionist also. I feel somehow its for the money. They like to take my money on the side when they can. My insurance company assures me that I just need 6 month medically supervised diet from 1 dr... SO are you seeing 2 different drs for your 6 month? sorry if I am confusing
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04-19-2008, 04:15 PM
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#4 | | Ldsjen0227
Join Date: Apr 2008
Posts: 2
City: Belleville State: MI | Managing our doctors
I am actually seeing a nutritionist and my doctor. Even though my doctor had me on a supervised plan and docmented my diet, weight and our goals in my medical record Blue Care still denied me. Which didnt make any sense, but the insurance company I think likes to play these games. Just to see if you are serious or not. I went in for a step 2 appeals and each of the 4 people on the panel had literally a realm of paper on me.
When I had talked to the insurance company every person I got gave me different answers and assured me. I would ask them to put it in writing. Good luck Ins companies are challenging.
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04-20-2008, 01:27 AM
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#5 | | Registered User
Join Date: Mar 2008
Posts: 29
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I got approved through BCBS of MN ... Right when I was starting this process, they had changed it to be 3 dietician visits and 3 physician visits.
I could have opted to use my primary care physician for the 3 physician visits but I chose to use the physician at the hospital. If you follow the 6 month diet and you are in the required BMI, you will get approved. The only way you will not get approved is if someone wasn't documenting things like they were supposed to. This is why I didn't use my primary care physician... because they're not familar with the specific protocol that the insurance company requires. They're pretty picky.. and if they don't see what they want.. you might have to go for more visits.
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04-20-2008, 07:18 PM
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#6 | | Registered User
Join Date: Dec 2007 Age: 29
Posts: 60
City: Bremerton State: WA |
I am doing a six month diet also, but I have Cigna. Find out from your insurance exactly what they require because everyone is different. You are probably okay with just your doctor but make sure they are writing 6 month physician supervised diet in the notes every month, what you are doing to lose weight and that all vitals are documented.
__________________ ShellShock 6-month Diet Feb-July 2008 Paperwork submitted to insurance 8/14/08. Approved by insurance 8/25/08. Surgery date: 9/30/08!!! Dr. Srikanth, Federal Way, WA Lost 19 pounds on pre-op liquid diet! Starting weight post-op 305 |
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05-11-2008, 05:38 PM
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#7 | | Registered User
Join Date: Mar 2008
Posts: 146
City: wtby State: ct | hi i also have to do 6months of nut. classes i have bluecare family plan of ct my 1st app were april30th my 2 is may 15th so my surgery maybe is around oct, nov. thats what my insurance told me. sill
__________________ SEMINAR 3/30/08,CON,1ST APP,4/30/08,2ND APP,5/15/08,3RD APP,6/20/08,4TH APP,7/15/08,5TH APP,8/8/08,6TH&LAST,9/3/08.   |
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