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Everything posted by ZenBunni
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As of 11/18/10 Anthem BCBS of CA changed thier policy. VSG is is no longer listed as experimental =) If you want to take a look its http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053317.htm (The full Anthem policies are http://www.anthem.com/wps/portal/ca/footer?content_path=provider/f0/s0/t0/pw_a112249.htm&label=Medical%20Policies&rootLevel=4)
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Anthem of CA - NEW GUIDELINES!!
ZenBunni replied to ZenBunni's topic in PRE-Operation Weight Loss Surgery Q&A
Your welcome!! I got approved on 12/3, after I had gone thru the appeals ... but its good to know that others don't have to now =) -
BCBS Aproval problems- Ayone with any type of BCBS please read
ZenBunni replied to warrior68's topic in PRE-Operation Weight Loss Surgery Q&A
You are VERY welcome. Hey we have to stick together =) However ... As of 11/18/10 Anthem of CA now approves VSG! (http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053317.htm) So you probably don't even need to file an appeal -
BCBS Aproval problems- Ayone with any type of BCBS please read
ZenBunni replied to warrior68's topic in PRE-Operation Weight Loss Surgery Q&A
YES. I have BCBS Anthem of CA and I got approved a week ago. My original claim was denied, investigational/experimental, so I submitted a modified copy of the letter that Fitat50 used (Ok so basically I combined a few different letters, but mainly was hers). I had to wait the mandatory 30 days, but on the last day before it expired I called and spoke with the appeals rep and he looked everything over and said "Great Letter! Yup your approved". I am attaching the letter. You have to modify it to fit your medical conditions, and your insurance ... but worked for me. Didnt even have to take it all the way to peer review! Stefanie VSG Surgery Appeal Letter.doc -
Please read this if you need to appeal (bcbs and other companies)
ZenBunni replied to mountain_lover's topic in Insurance & Financing
Thanks for posting that again. I did see it, but its easy to forget where you find threads :w00t: I am currently going into my appeal with BCBS of CA so I am very grateful for all the ammo I can get. -
Need help with appeal letter to BCBS Michigan
ZenBunni replied to Cautious2010's topic in Insurance & Financing
Thanks Jeani, I did get your letter. That and other letters are a big help in compiling the info. Eydie, I have BCBS of CA. I got my denial at the end of August. As I understand they are one of the last holdouts of the blue cross families. So I am sure as Murphy's law goes, as soon as I send all this in they will change their coverage policies LOL - :laugh0: Thanks everyone! :001_tt2: -
Thanks - I am trying to keep my spirits up and keep thinking positive about it :thumbup:
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Need help with appeal letter to BCBS Michigan
ZenBunni replied to Cautious2010's topic in Insurance & Financing
I am currently putting on my boxing gloves with BCBS, so these are very helpful. THANKS! Stefanie -
Can I pls get a copy of that letter? I am currently putting together my appeal to BCBS and would like all the ammo I can get :cursing: dsrtwnds@aol.com Thanks!! Stefanie