BCBS of TX - 5 years proof

[bamagirl36526 0]

I have been overweight for all my life but I do not have the complete record of information I need information of 2006 I did not go to the doctor at all that year. I consider this a blessing but now that I am pre-hypertension - blood pressure - and thyroid problems I can't get my lapband. Any suggestions on how I can prove I was overweight for that year. I have weight watchers information would that work??? Thank you

[Reshee 0]

I'm from Texas and have BCBS of Texas. The only preexisting condition I have is Thyroid condition. They approved me the first go around with me only documenting on a form that Dr. Kim provided.. Listing the different weight loss programs and diets that I have tried with dates and durations (not exact). No doctor documentation at all. Where in Texas do you live and who is your doctor. My lapband Doc (Dr.KiM) handlied all the paperwork and knew all the hoops needed to be jumped through. I started my process in November of 09 and will have my surgery tomorrow. I was afraid they would not apporve me because of no preexisting conditions like yourself. Normallly they want you to have the problems you mentioned that you have. I think I was approved because of Dr.Kims office knew exactly how to document and gives the insurance company the required paperwork for them to approve. Good Luck!:thumbdown:

[Humming Bird 275]

The weight watchers info is sure worth a try. I would try everything in every form you can dig up. I would also appeal if you get turned down the first time.

If all else fails, you could do self pay like I had to. It's a bummer to make payments, but I got banded.

[Cocoabean 430]

I have BCBS California HMO or whatever it is called. I appealed the 6 month diet requirement by using weight watchers records. They accepted it for that. I don't see why they would not accept it as proof of weight.

Here in California weight watchers scales are certified by the state weights and measures board of equalization. So, even more accurate than a doctor's scale. I'd submit it!

Best wishes!

Edited February 18, 2010 by Cocoabean
used the wrong word

[jalivia2 0]

I have BCBS of TX too and live in the Houston area. So far, I have only needed to have 3 nutritionist visits and a psych evaluation. I have 2 nutritionist visits left before everything is submitted for approval. Hopefully, I will be approved. I have a BMI of almost 42 with no co-morbidities.

[bamagirl36526 0]

Thank you all for the wonderful advice....I live in Alabama but I have BCBS of TX company is based out of Texas I am going to try to submit my weight watchers information and see how that goes.....Wish me luck I sure do need this band bad

[Cocoabean 430]

As Humingbird said, appeal it if you get turned down the first time. Many, many of us have appealed and won!

Don't give up hope. My own opinion is that the insurance companies find any way they can to turn us down in hopes we'll give up and go away. If you can make a good argument on appeal you can win. In the mean time, keep getting your ducks in a row with other requirements they might have like nutritionist visits, psych evals, blood work and the like.

Best wishes!

I did!

[DrHekier 0]

Work with your doctor's office. Each policy is different. One person's BCBS of TX policy may have different requirements than another person's

Regarding what might work: we once had a patient that lacked one year of her five year weight history as do you. We provided a picture of her that was taken during her "missing year" which showed that she was at a similar weight as noted on her doctors notes for the years before and after.

Good luck!!

[suman78 0]

nice advice of my friend. its help full to all surgery patient.

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