BCBSIL more info needed

[Monica_Lynn 0]

So I have been waiting all week (impatiently) for my approval. When I called this afternoon to check on the status, it wasn't the news I wanted. All of the information is in my file with the exception of my co-morbidity failures. What exactly does that mean because my PCP hasn't even been presented this before. Needless to say, before I get this initial denial letter I am being proactive and went to my PCP today (within 2 hrs of getting this info) and he took down all of the information and writing me another letter. I am hoping this will be enough to suffice the medical review team and they will approve this. I was hoping to have my surgery date in September because I have been on this journey since January and went thru a policy change right in the middle (from 3 months to 6 months medically supervised weight loss). I am so NOT giving up, especially since I have read many postings that after one appeal there was an approval!

[MeMeMEEE 206]

This sounds kind of mixed - comorbidity failures? A comorbidity would be like high blood pressure, diabetes, etc. The failure part to me sounds more like you attempts at dieting and failing?? Hope you are able to get them what they need!!

[Monica_Lynn 0]

The person I was talking to didn't really know what was needed. I found out last week what was needed and they actually had the paperwork but I re-faxed them the information too. The following day the patient coordinator at the surgeon's office also faxed that information then followed up with a call pointing out where the information is they were asking for. I called yesterday and there was no update so I am going to call again today. The surgeon's office is due to call tomorrow so I am optimistic I will have my approval this week!