BCBS dropps supervised diet requirement. - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

chtinkham06 · 09-21-2009, 01:26 PM

I just received a packet o' info from Blue Cross Blue Shield, about the criteria for WLS and they no longer require a medically supervised diet.

now the only criteria is the BMI (35 + co_morbids) (over 40)
and a letter of medical necessity, and a psych eval.

Yeah, no 6 month diet for me!!! Its not like my doctor needs to watch me get uber hopeful, yet again, then get depressed when the weight slams back.

Wish me luck, everyone, I'm so close to my rebirth.

netta · 09-21-2009, 05:28 PM

wow, hopefully you read it correctly, I think most have a supervised of some sort from your PCP. I would double check, just to be safe.

Laureate · 09-21-2009, 05:30 PM

Quote:

Originally Posted by chtinkham06

I just received a packet o' info from Blue Cross Blue Shield, about the criteria for WLS and they no longer require a medically supervised diet.

now the only criteria is the BMI (35 + co_morbids) (over 40)
and a letter of medical necessity, and a psych eval.

Yeah, no 6 month diet for me!!! Its not like my doctor needs to watch me get uber hopeful, yet again, then get depressed when the weight slams back.

Wish me luck, everyone, I'm so close to my rebirth.

Good luck, you lucky dog!

sarah626 · 09-21-2009, 05:38 PM

That six months seemed like a year -- and, shockingly, I gained weight on my "supervised diet." Seemed like a waste of time to me -- maybe BCBS figured that out. Like Netta, however, I would double check (almost sounds too good to be true). I hope it is true -- and let us know when you get your date set.

Good for you!

Anne with an "e" · 09-21-2009, 05:39 PM

For what its worth and as much as I HATED the thought of doing a 6-month diet prior to approval, it really turned out to be very beneficial. I feel like I am so much more prepared for all of this than I was 6 months ago.

mistymee · 09-21-2009, 05:46 PM

I have BCBS (of MA) and did not have to do any supervised diets. It was a matter of weeks from the time I approached my PCP to having my approval and surgery date. The whole process from that first PCP appointment to surgery would've been less than 3 months if I'd not wrecked my knee and missed my preop admissions tests. This all happened in the end of 2007.

Helena · 09-21-2009, 07:20 PM

I have bcbs of mass...No supervised here either....
All I needed was a 35 bmi with 2 co-morbids or a 40 bmi..

MissKeaton · 09-21-2009, 07:48 PM

I havce Anthem BC of Cali. I got a letter the other day telling me I didnt need to do it, just to be aproved i had to go ass backwards through the program here lol. PCP letter showing that i have attempted and failed weight loss, Surgeon has to do a health check and physical, Dietitian, Psych Eval.

Then i called today to make sure the PCP had sent in the letter. This new lady acted like she didnt give a crap and told me i had to do a 3 month diet. I was like.. uh no. So i called the surgeon office, and the new girl transfered me to the dietitian and i havent even seen her, so im sure she wont call me back. UGH. I really dont wanna get skrewed.

I got this letter from Anthem saying i had 60 days to get all this done or they would deny me and i would have to start over. So my appts are October 8th and the due date is Oct 19th. The one that didnt give a crap said she would call it in and close the claim so i wouldnt have to worry about it. I was like what the hell would you do that for??? so i was like um i'll call you back, and dont close it till i do.

I'm a lil nervous now.

Sorry for venting on your thread. Hopefully the BCBS goes with Anthem too :P

netta · 09-21-2009, 08:05 PM

wow excellent to all, and for BCBS

Samantha. · 09-21-2009, 10:55 PM

I am from Mass and have Blue Cross Independence (National BCBS) out of Pennsylvania. I didn't have to do a 6 month either. But I did have to have the nutritionist, pyschologist and letter from PCP documenting attempted weightloss.

My advice is to find a team that works together--> I go to a place that is two surgeons, three nurses, a pysch and a nutritionist all certified and knowledgable specifically with WLS. And it's nice to see the pysch and have the nutristionist ask how things are going! Plus I pay a $500 out of pocket fee and I can see any of them at anytime for as long as I feel I need to and as often as I need to as long as I set up an appointment, without being billed.

Good Luck! Hope to hear more good news about your date on its way!