Insurance Woes!

danaclark2 · March 8, 2006

Just when I think all I have to do is wait--wait for the hopeful "Yes, we approve you!", they ask for more information.

My surgeon's secretary sent in all the needed info. :psych. eval., letter from doc. (that included all the info. that the insurance company wanted), etc., but after calling them (BCBS of TN) Friday, they said that they needed documentation that I had been on a weight loss program, monitored by my doctor for six months. The letter from my doctor said all of this--I guess they needed his clinical notes. I saw my doctor in August 2005--he put me on phentermine. I saw him again in Sept., October, missed November, and then saw him in December--so about five months. My doctor's secretary forwarded all the clinical notes (with my weights, etc.) to BCBS of TN. I'm hoping this is all they'll need. I HOPE THE ONE MONTH THAT I MISSED SEEING MY DOCTOR IN NOVEMBER WILL NOT DISQUALIFY ME FROM GETTING APPROVED. I stopped the Phentermine in December because it was making me crazy.

BCBS of TN also wanted proof that I've been obese for over five years. The only doctor who has this documented is my gyn. I called his office--and they said it would take 7-10 days to get that info. to me. It just seems to drag and drag and drag. Oh, how I want to be on with this...

Thanks for "listening."

Feel2Young2B40 · March 8, 2006

Good luck and keep your chin up! Keep after them in a nice way and ask your doctor to do all he can to get the approval. Again, good luck! Laura:gluck:

picardy3 · March 8, 2006

Hang in there Dana! :gluck: :gluck: :gluck:

Just keep after them. I swear some times they just want to make life difficult. :censored: :censored: :censored: :censored: :censored:

Audra sending you a big hug and the good luck that I had

Mvpo8961 · March 8, 2006

Dana I really understand how you feel. I saw my GP in September 2005 to start a six month WL program. After repeated assurances by my ins. coordinator that lapband was a covered benefit I discovered it was not. But only after asking to see the policy in writing. Fortunately it was one hour before closing on the LAST day to switch ins. for the year. The other ins had coverage for lapband. The only reason I didn't switch before was because I was already 4 months in to the WL program with my GP.

Now after all that I had to wait for new insurance cards to give to my surgeon. Then they mailed my paperwork in. About a month ago now. I have called my insurance company daily for the last two weeks to see if it had arrived. No has been the daily answer. So when they asked me for the third time to ask the surgeons office to resend everything by fax I figured out something must be astray. So I called ask the surgeons office to resend by fax last week. I was told by the insurance co it would take 48 hours to be in their system. Guess what five days later the answer is still no, nothing has arrived from the surgeons office.

I honestly am about ready to go pick up everything and DRIVE it to wherever it needs to go in the US!!!!!!!!!!!!!!!

It would have to be less stressful that the waiting and wondering if it has ever even got there.

I fully believe any and all catastrophes such as the shifting of the world's land masses, cosmic solar flares, sucking black holes or any other natural or unnatural disaster that can befall my paperwork will do so.

So I understand exactly how you feel. I just want to be a screaming meme. M:drama:

Thinjen · March 8, 2006

I don't want to discourage you, BUT BC/BS of Tennessee has been a real pain for me. I have been fighting with them since last June. Feel free to pm me. We'll need each other to get through this. Whatever you do...don't give up.

beccamay · March 8, 2006

my insurance requested the same information, since i had humana, they said it has to be 6 months consecutive documentation. so if i missed a month then i would have to start over. I would contact them and see if you will have to.

Busy · March 9, 2006

Dana, hopefully the insurance co will take the notes your doctor office sends to them and not count the lost month. I have to have the 6 months of monitored weight loss, started in Dec. and based on replys to your post, I will not miss a month. Will keep the fingers crossed for you.

PJ