BCBS - What are they thinking?

[dpingl 0]

AFter reading some of these, I really am wondering if I am REALLY approved. I got a VAGUE letter ALSO stating as follows:

We have completed our review of your request for coverage of LAPAROSCOPIC GASTRIC BANDING under the Yellow Roadway Corporation Benefit Plan. Base o the information reviewed, we are pleased to inform you that coverage is avalible. All covered services are subject to screening for allowable charges.

Its goes on to now that this letter does not guarantee payment etc...??

Does that sound as if I am approved? I have a meeting with my Surgeon TOMORROW, I am excited and nervous!

[wantlapband 0]

dotofoz,

I decided to go to the doctors office psych. They use the same one. I went to mine first since he has known me for a few years..but he wrote nothing about WLS...it was a general 3 letter that was so impersonal.

I go to day to see the psych.

I'm worried about my insurance carrier BCBS Anthem (nh)...I hope they approve me, the paper work gets sent in after this visit.

[wantlapband 0]

AFter reading some of these, I really am wondering if I am REALLY approved. I got a VAGUE letter ALSO stating as follows:

We have completed our review of your request for coverage of LAPAROSCOPIC GASTRIC BANDING under the Yellow Roadway Corporation Benefit Plan. Base o the information reviewed, we are pleased to inform you that coverage is avalible. All covered services are subject to screening for allowable charges.

Its goes on to now that this letter does not guarantee payment etc...??

Does that sound as if I am approved? I have a meeting with my Surgeon TOMORROW, I am excited and nervous!

I hope it is an Approval letter! YEAH..keep us posted:)

[dotofoz 0]

:bandit

Wantalalpband: Well, let me know how the visit goes, I wish you the BEST! I don't think these ins. cos. realize the mental torture they're putting us thru while we have to play their games! Oh btw, is your anthem fep? Mine is.

[officegirlblues 0]

Hey everyone. I have BCBS of Alabama and they do NOT cover the band. They will cover gastric bypass any time but not the band. I know. Doesn't make sense to me either. I've been trying for over 3 years to get the band and the doctors here won't even file it anymore. I've had one actual denial and I've seen a couple of different doctors and they all say there is no point in filing. BCBS of AL considers this surgery investigational.

I've written to the State Insurance Board and basically what they said was that each BCBS is different. Alabama chooses not to cover it for whatever reason and there is not a whole lot that can be done about it. All of the states around Alabama cover it so we're hoping maybe it will trickle down to Alabama eventually. Unless you have a kind of self-insured BC plan for a very large company you are just out of luck. Frankly, I'm getting tired of waiting and am considering just going ahead and having the bypass done.

Congratulations to everyone that has had it approved.I think its great and I am so happy for you! :clap2:

Hope