Peer To Peer Review

[krazykristy1998 11]

I was supposed to have surgery May 23rd. BCBS Of AL denied it because of the nutrition part. They said that that the nutrition part that I did with my doctors office wasn't good enough. So I am waiting on a Peer to Peer Review that should be done this week. So I am hoping that they approve my surgery.

[xavtay2 85]

KrazyKristy,

Good luck on the approval I am doing everything I can to have my surgery approved I was denied because of the facility...nothing to do with the doctor. Prayerfuly it will work out for you.

Keep us posted

Blann

[sharonk 23]

I am going through the same thing....they denied it because my original paperwork from my pcp who supervised my 6 months is not sufficient and that there was no documentation showing him working with a nutritionist. Its all so confusing and so generalized so i have submitted things over and over again trying to get it approved. Not to mention a half a**ed peer on peer review (another stupid story). After having my human resource contact, at work, contact her peeps i was told i needed documentation from a registered nutrionist/ dietician for the FULL 6 months and not just from our initial meeting. LUCKILY, i attended 7 months worth of support group meetings and the band drs office's onsite nutritionist was the group leader. She gave me each month's sign in roster that showed my attendence and over 30 pages of documentation showing what was dicussed at each meeting. I also had to get my pcp to give me his office notes for each of my visits. (That was like pulling teeth for some reason)

NOW, im back to waiting as i am now re-applying after 6 months of appeals.

Good luck, i hope your peer on peer goes better than mine went!!

[sharonk 23]

I am going through the same thing....they denied it because my original paperwork from my pcp who supervised my 6 months is not sufficient and that there was no documentation showing him working with a nutritionist. Its all so confusing and so generalized so i have submitted things over and over again trying to get it approved. Not to mention a half a**ed peer on peer review (another stupid story). After having my human resource contact, at work, contact her peeps i was told i needed documentation from a registered nutrionist/ dietician for the FULL 6 months and not just from our initial meeting. LUCKILY, i attended 7 months worth of support group meetings and the band drs office's onsite nutritionist was the group leader. She gave me each month's sign in roster that showed my attendence and over 30 pages of documentation showing what was dicussed at each meeting. I also had to get my pcp to give me his office notes for each of my visits. (That was like pulling teeth for some reason)

NOW, im back to waiting as i am now re-applying after 6 months of appeals.

Good luck, i hope your peer on peer goes better than mine went!!

[krazykristy1998 11]

Good luck to you. I know it can me very frustrating.