Federal BCBS Wellmark Iowa - Approved

[iowagirl 0]

I recieved my approval for VSG today! Got a letter in the mail. I have Federal BCBS Basic administered by Wellmark of Iowa. I know the Dr. that is doing my surgery had never before submitted for federal bcbs coverage and they were unsure as to whether or not it would be approved - in fact they even had an appeal plan in place in case it was not!

Something interesting to note on the approval form: "Prior approval is not required for this procedure for FEP however; a medical necessity review has been completed. Medically approved 43775"

So federal employees in Iowa - Wellmark is approving VSG based on medical necessity. I'm guessing it's only a matter of time before coverage spreads to their other policies also. Keep the faith and don't give up!

I know there are other federal employees being denied - so feel free to pm me with any questions - I'll help if I can!

[Dansha 16]

Hey Iowagirl. I have Federal BCBS of Kansas City. I have a question. What was the timeframe from the surgeon's office submitting the paperwork till you getting your letter? My insurance case manager from my surgeon's office submitted the necessity letter on Wednesday the 14th and I was wondering how long it took to get approved. Thanks.

Deb

[iowagirl 0]

Dansha - from submittal to approval date was 18 days counting weekends and a holiday in there. They must have sent me the approval letter immediately because I got it two days after that. Good Luck!

[Cancel 1]

Congratulations. Keep us posted.

[Dansha 16]

Thanks for the 411. Best wishes on your up coming surgery. Please keep us updated.

Deb

[ShellieB73 0]

Many congrats and thanks for the information....I am waiting for the traditional Wellmark of Iowa policies to be updated as well. I have been contemplating submitting and then asking for an independent medical review if denied, but I have a feeling it will be soon!!! I guess I am trying to be optimistic Meanwhile...I continue to be frustrated with myself after removal of my band.....argh!!!!

[dentonpl 0]

I have Fed BC/BS of Colorado. I received my denial letter yesterday. Is there any chance I could get a copy of your approval letter? I would certainly appreciate any ammo I can get!

Thanks so much! -Lisa

dentonpl@aol.com