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Major Bump In The Road



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I have highmark blue shield. They said I was denied because I have a BMI less than 50. Thats all I got. The denial letter is in the mail & apparently no one there has the power to fax me a copy. And, yes I was approved for Bypass or Band. Not the sleeve.

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I am sending you a PM.

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I have highmark blue shield. They said I was denied because I have a BMI less than 50. Thats all I got. The denial letter is in the mail & apparently no one there has the power to fax me a copy. And' date=' yes I was approved for Bypass or Band. Not the sleeve.[/quote']

I have Highmark Bcbs & am going thru the same thing only I knew I would likely get denied initially. But then I called highmark to check the status & was told it was approved & everything was a go only to get a denial letter. Called to see what i needed to do & of course got the run around. But they did tell me i was approved for the band or bypass. I dont want either if those. So my surgeon called & did the peer-2-peer review and got nowhere so I will be sending in my 1st appeal letter this week. Fingers crossed they will reverse their decision. I am sending in a copy of the asmbs updated position statement on the vsg that was released on 10-28-11 so im hoping that helps. Good luck to you in your journey. Keep us updated!!

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I hope it all works out & I'm not giving up even though I want too. Tasherie that letter is phemoninal. Would you mind if I used some of it? @ Bella, it sucks having to do this. Have you appealed? And do you have a pre-op diet? I'm hoping my Surgeons word will help, if not I will be pleading my case to the "board", which is basically one person. Im also on month 7 :(

Sure I don't mind. If you have any questions just IM me.

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