Question:
Is there ANYONE with Blue Cross/Blue Shields of GA ever been approved for WLS??

I have BC/BS of Ga... I am in the process of approval... they have requested additional info & today I have a doctor appointment w/ my PCP to get the info. My concern here is that I have read nothing BUT BAD results from people w/ BC/BS. If you read my profile you will see the start of my journey. I just wonder if there are people that do get approved w/ my insurance. Am I fighting a losing battle?    — Beth G. (posted on May 24, 2002)

May 24, 2002
HI read my profile and contact me---I have BCBS of Florida--
   — Linda L.

May 24, 2002
It depends on your employer's policy with BCBS. I have BCBS of Georgia PPO, and it does cover WLS. However, it is my understanding that, due to the huge volume of requests, they have started this: When they receive a letter from the surgeon requesting your surgery, they give you 10 days to provide a psych letter and thyroid panel (lab) results and medical clearance letter. In most cases, you can't get all that done within the 10-day time limit, and you are automatically denied. Dr. Champion's office and Dr. Duncan's office both know this, and are requiring their patients to get this information BEFORE coming in to see the doctor so that the office will have these documents to send WITH the Letter of Medical Necessity (LOMN), so that there won't be an unnecessary denial. Just check with your doctor's insurance department. They should be aware of all the hoops you need to go through. Good Luck!
   — crawford1213

May 24, 2002
I have BCBS of Ga POS, I have it through Bellsouth. I was approved within a week and have a surgery date of July 2. I think a lot would depend upon the plan that your company has with BCBS. You could request a Summary of Benefits and that should list everything they will cover and won't cover and all the exclusions. Mine stated under obesity that it would cover surgery if 1. a bmi of over 40 2. if the bmi was under 40 comorbities were applicable and 3. that the patient be over 18. There was also an exclusion in my policy reqarding weight loss surgery but that was there for people who do not fit the criteria of obese and just wanted to lose weight. Check it out while you're gathering the additional information and see what your policy says.
   — Wendy C.

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