vhowley

Ok...so I survived my 1st BM yesterday afternoon....but the GAS last night....wow! I literally didn't know I had it in me! Sent from my iPhone using the BariatricPal App

I am 6 days post op and was just wondering about when I might expect a BM. Will be heading to Walgreens now for some stool softeners. Thanks for the HILARIOUS, necessary and informative post!! Sent from my iPhone using the BariatricPal App

I have surgery scheduled for 17 May 16. BMI is 39 - have Moderate sleep Apnea. Did medically supervised diet from Dec 2014 - May 2015 and every possible diet known to man, multiple times. Reason for denial is that the 3 month medically supervised diet was not within this last year. Nowhere in the 2016 FEP BCBS brochure does it say WHEN you had to participate in a 3 month program. I was also medically supervised from Apr 2006 - Dec 2006 when I represented Pennsylvania on Season 3 of the Biggest Loser. Can anyone advise on how best to challenge this? I don't want to wait another 90 days to check a block. I've been battling and battling and battling for years.... Sent from my iPhone using the BariatricPal App

The BCBS FEP advocate agreed that the verbiage leaves room for interpretation. You read it as "3 months JUST prior to surgery"....I read it as 3 consecutive months prior (read BEFORE) surgery. Sent from my iPhone using the BariatricPal App

I just have BCBS Federal (FEP). If you look at my earlier posts I have contested the wording in paragraph for medically supervised program... Sent from my iPhone using the BariatricPal App

Welllllll....I submitted all my paperwork on the 10th of May...and went ahead with the surgery on 5/17 as "cash pay"...because I had already taken soooo much time off from work in preparation for the surgery and other medical appts. I received this letter from the Reconsideration department...which frustrates me...because they are looking for program participation between May '15 - present. My main argument for the reconsideration IS the lack of definition for "prior to surgery" verbiage. Sent from my iPhone using the BariatricPal App

Thank you Sharon! Great suggestion! I'm dying to know how the peer-to-peer discussion went. Apparently, my doctor made the call in between surgeries, so I'll have to wait til tomorrow. Sent from my iPhone using the BariatricPal App

I received my denial letter and drafted an appeal...would appreciate any feedback/suggestions on how to improve it. My doctor is doing the peer-to-peer call this afternoon...hoping for a miracle approval so I won't need to appeal... Sent from my iPhone using the BariatricPal App

Thank you! I haven't received the denial...only the surgeon's office has...so far. I logged into fepblue.org to see if I could find the denial, but it's not there yet. Sent from my iPhone using the BariatricPal App