Did anyone get approved for a revision with BCBS Federal?

[babygirlinokc 0]

Just wondering if some of you were approved with BCBS Federal? I was denied and I'm appealing. BCBS FED would not tell me the reason why it was denied they only said, the claim did not meet the criteria. That is all they could tell me over the phone. They said I would have to request this in writing. I am appealing this and asking in writting what was the reason it was not approved. I'm also requesting for a Bariatric Surgeon to be one of the consultants in the Appeal and Grievance Board.

The band did not work for me at all. I was always starving. I hated it. I lost 17 lbs and then gained it all back and then some.

Has anyone been approved for your revision from band to sleeve with BCBS Federal?

Thanks.

Thanks.

[brittu 42]

I'm still fighting. I hired the Lindstroms at Obesity Law to represent me on this final round that bounced my case from the local Regence office back to Washington DC. There has been one delay after another (the DC office seems to have lost my case and has had to start over). At this rate, 1 year since my slip, my weight has gone up so much I'll be back at the original qualification for non-revision WLS in no time (she says with grim irony). I am not feeling hopeful that I'll win. I did prevail on band removal, that's out, but I need the VSG. I'm disappearing again under a layer of fat. It makes me too sad to talk about really. One way or the other I hope it'll be over soon and I'll know whether they're paying for the surgery or I am.

Best of luck to you. I'm glad to have the band out, after it slipped I was in pain for months on end while I fought to get it out. I strongly recommend the Lindstrom's, they've been amazing. Just having someone fight for me after fighting the first two rounds myself was worth the money. And frankly, I think they have incredibly reasonable rates.

Take care,

Britt

[Donna_in_Texas 0]

I got my approval in 24 hours. I am on BCBS Fed plan in Texas. Remember that most surgeries have to be pre-approved before hand. You mentioned that they "denied the claim". Do you mean that you had the surgery and then sent in the claim? If so, that may be the reason for denial.

My surgeon sent in the pre-approval request to BCBS. He is a preferred provider with BCBS (I am on the basic option so I must use preferred providers in order to be covered for anything.) They approved 2 day hospital stay and the VSG procedure. No hoops the jump through, nothing. I was very amazed.

Good luck to you. Remember....as a fed employee you have 2 level of appeal rights. One with BCBS directly and then with OPM. I recommend sending them an official appeal letter.

Hope this helps,

Donna in Texas