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Re: Anthem BC/BS

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Are you a federal employee with BCBS Anthem in Ohio? The federal standard

plan has paid for the DS for several folks in this group. I just went

around in circles with BCBS in NC. They don't do predeterminations anymore,

just precertifications for the hospital stay. They won't pay til after the

surgery, and the docs submitted prove medical necessity. So, I think it's

on a case by case basis.

I'll be asking folks that had DS with Federal BCBS standard to email me. I

had a list, but my new computer hard drive crashed, and took it all. So,

I'll have to start over. My surgery date is 01-15-02 --Yeah !!!

Siri

Re: Anthem BC/BS

> Hey, .

>

> Good to see you around these parts. Did you get my last private

> message? What do you think about any of those ideas? Are they non-

> starters for you?

>

> Best,

>

>

>

> > Anyone had any luck getting Anthem Blue Cross /Blue Sheild to

> approve

> > Duodenal Switch?

> >

> > Everything i have read indicates they consider it " investigational "

> and that

> > they will not cover it under any circumstances...

> >

> > Even the center i am thinking about using,

> newlifesurgerycenter.org, says

> > that BC/BS will not authorize it..

> >

> > :( i really think that DS is for me... They [bC/BS] will approve

> RNY, but

> > that's it...

> >

> > Distressed,

> > -

> >

> > _________________________________________________________________

> > Get your FREE download of MSN Explorer at

> http://explorer.msn.com/intl.asp.

>

>

> ----------------------------------------------------------------------

>

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Hey, .

Good to see you around these parts. Did you get my last private

message? What do you think about any of those ideas? Are they non-

starters for you?

Best,

> Anyone had any luck getting Anthem Blue Cross /Blue Sheild to

approve

> Duodenal Switch?

>

> Everything i have read indicates they consider it " investigational "

and that

> they will not cover it under any circumstances...

>

> Even the center i am thinking about using,

newlifesurgerycenter.org, says

> that BC/BS will not authorize it..

>

> :( i really think that DS is for me... They [bC/BS] will approve

RNY, but

> that's it...

>

> Distressed,

> -

>

> _________________________________________________________________

> Get your FREE download of MSN Explorer at

http://explorer.msn.com/intl.asp.

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Dr. Hess routinely gets Anthem to authorize although they don't pay real well

so he requires $2500 upfront from anthem patients.

Dawn

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting!

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