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Letter from insurance

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mrsyellis

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Today I received a letter from bcbs/il about the necessary procedures to be deemed medically necessary... The letter was everything I expected from reading all of the posts on LBT but when I turned it over,it stated I needed 12 months of supervised dieting- I liked to died on the spot!! I called them right away only to learn that I was sent an old version of the letter and it is in fact only 6months needed. WHEW what a scare. I have a question- are you supposed to loose a lot of weight on the clinical diet? What exactly is the insurance looking for during the 6 mont period? Any help would be appreciated!! Only 22 days left to my consult-BTW - BCBS/IL is sending me a new corrected letter!

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Today I received a letter from bcbs/il about the necessary procedures to be deemed medically necessary... The letter was everything I expected from reading all of the posts on LBT but when I turned it over,it stated I needed 12 months of supervised dieting- I liked to died on the spot!! I called them right away only to learn that I was sent an old version of the letter and it is in fact only 6months needed. WHEW what a scare. I have a question- are you supposed to loose a lot of weight on the clinical diet? What exactly is the insurance looking for during the 6 mont period? Any help would be appreciated!! Only 22 days left to my consult-BTW - BCBS/IL is sending me a new corrected letter!

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You probably won't be able to get a clear answer to this out of the insurance co., but you can try. I'd suggest two things...talk to the insurance expert/billing person at your surgeon's office as they deal with your insurance company requirements all the time (I've gotten the best info. about my insurance from this person...mine said "If you fall below the 35 BMI then you won't need the surgery." They can't legally tell you not to lose weight, but if you ask the right questions they'll 'tell you'.). You can also do a post (put the city/state and insurance co. name in your title) on the insurance forum here and you'll get replies from others who have the same. It's so different even within the same co. I am not allowed to fall below the minimum 35 BMI before approval, and also I should not lose much weight (5-10# ttl...I'm expected not to succeed at loss), but others here are expected to lose like 10% of their body weight and some are allowed to fall below the 35 or 40 BMI thresholds (I have BCBS also, but the requirements are different even within my same state of PA). Good luck (and make sure you're well above your threshold for the consult as they'll weigh you).

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