thisislou 13 Posted July 1, 2010 Great news?. I check BCBSIL procedure web site every few days to see if it has been updated for the sleeve ? and it has been updated today. I could not find the words "investigational" with "sleeve" - If I'm reading it correctly - VSG is now accepted.... I was a few weeks too early - I was denied and approved after I did the appeal... Share this post Link to post Share on other sites
stephany48463 1 Posted July 2, 2010 OMG I HOPE You"re Right... maybe my doctor not being on the ball is a good thing! I've been done with my 6 month diet doc which was the last thing I had to do but it is taking my doctor forever to get the info over to my surgeon so that I can send it in again! I just want to get approved and scheduled!! I lost 40 lbs on my 6 months but have been eating out of frustration and anxiety and put 5 back on! I just want to know if I am going to have to appeal or not! Share this post Link to post Share on other sites
thisislou 13 Posted July 2, 2010 wow 6 month - The BCBSIL requires a 3 month supervised diet and your BMI number they consider is your initial one: "Documentation of active participation in a comprehensive, non-surgical program of weight reduction for at least three (3) months, occurring within the twenty-four (24) months prior to the proposed surgery. (NOTE: The initial BMI at the beginning of a weight reduction program will be used to meet the BMI criteria for the definition of morbid obesity used in this policy.) " Lou Share this post Link to post Share on other sites
ShellieB73 0 Posted July 2, 2010 I'm so hoping that Wellmark BCBS of Iowa will hurry up!!!!!! My patience is wearing thin!!!!! Share this post Link to post Share on other sites
stephany48463 1 Posted July 3, 2010 I know Lou but my stupid employer Walgreens requires a 6 month...I have been pretty bitter about that for the last 3 months!! but its over now hopefully my surgeons office will get it submited in the next week! Share this post Link to post Share on other sites
mila1013 0 Posted July 3, 2010 wowo that is great news with BCBS for you hope it continues... Share this post Link to post Share on other sites
KabinKitty 11 Posted July 5, 2010 :001_wub: :001_wub: LOU, I THINK I'M IN LOVE WITH YOU!!! :001_wub: :001_wub: :001_wub: How nice of you to keep checking for all of us BC/BSer's out here who are waiting to get approved by them. I have my psych evaluation tomorrow, along with my second visit with the nutritionist. Then I have to get my butt to two more support meetings (July 26th & Aug 23rd), one more visit to the nutritionist and one with an internal medical doc (required by the surgeon) both on August 20th. Then my packet should be sent in to the ins co. Woo Hoo! :thumbup: Share this post Link to post Share on other sites
biancafg31 0 Posted July 26, 2010 Do you have by any chance a link to their actually converge? I see they have a flash on the decision making but I would like a text since I have Anthem BCBS and they denial and I am appealing. I will like to attach they policy to my appeal letter. Thanks, Share this post Link to post Share on other sites
thisislou 13 Posted July 26, 2010 home page : BCBSIL/Provider Medical Policies on Fyiblue then i search for "sleeve" then "Bariatric Surgery " Lou Share this post Link to post Share on other sites
biancafg31 0 Posted July 26, 2010 i got it, u r right, i didn't scroll down to accept the rights, this is why i couldn't search. Thanks for the quick reply. Share this post Link to post Share on other sites
Donna4545 13 Posted July 26, 2010 You could also send them BCBS ND's new policy approving the sleeve with your appeal--but I got the info on the phone and don't know where it is on the web. Share this post Link to post Share on other sites
biancafg31 0 Posted July 26, 2010 Donna, thanks i found it. u just had the surgery a week ago? How r u feeling? Share this post Link to post Share on other sites
stephany48463 1 Posted July 27, 2010 hey guys.... just thought I'd let ya know that I finally got my approval from BCBS IL! they actually denied me based on investigational even though they changed their policy and I had to call them and tell them the policy had changed, 6 calls later they finally approved it!! Share this post Link to post Share on other sites
KabinKitty 11 Posted July 28, 2010 This is the only information I can come up with for myself. I have Anthem bc/bs of Ohio-Blue Access PPO. I don't know if this link will work. SURG.00024 Surgery for Clinically Severe Obesity This states that the sleeve is still investigational and is not covered. I just don't know if this is the current status for Ohioians. ? Share this post Link to post Share on other sites
biancafg31 0 Posted July 28, 2010 Jeannie, You r right, this is the policy, they didn't update it since January. I am going to appeal today. Did you got approved for VGS? Share this post Link to post Share on other sites