Bcbsil Approved!

[raindrop 5]

I'm approved thru BCBSIL. Their approval was easy. The problem was I had to get approved thru an outside agency because my insurance is thru the city of chicago and they have their on guidelines. It took a week for an approval that should have only taken 2 days. I called every day for 4 days and finally on Friday I talked to the the nurse. It took her all of 1.5 min to look over my paperwork and say she would send it on to the doctors. My approval came thru on Tuesday!!!

[FatGirlSlim 115]

Congrats on your approval!!!!!

[BKMama 179]

Congrats! I'm in the Chicago area as well and have BCBS. I am hopeful my approval goes as well as yours! If you don't mind my asking, who is doing your surgery? I'm going through Northwestern. :-)

[raindrop 5]

Thank you!!! I'm having mine done by Dr Cahill at St Margaret Mercy in Dyer In.

[Misstxdiva 73]

Congrats

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[Delta_35 129]

Congratulations!!!! I just got approved through Aetna, so our surgery dates might be close togather. Its looking at May 16th for me

[MinaT 669]

I had my consult with surgeon yesterday and he said he will dictate my letter and they will get it to BCBSIL by Friday (tomorrow). I'm excited and nervous at the same time. I was told it could take 4-6 weeks for approval and I keep reading how people are receiving approvals from 2 days to a week. I hope I will be as lucky. I will most likely call bcbsil next week to see if I could push it along. I have done so well the past six months, following a low carb diet, using http://myfitnesspal.com to track my foods, my Water intake, my exercise. I have spent 6 months drinking Pure Protein whey Protein shakes for breaksfast to get used to high Protein Shakes for me 2 week pre-op.

Unfortunately, I found out I have Lupus, and I was even taken to the hospital for a bought of pleurisy due to the Lupus and now I'm terrified my insurance company will deny me because I have an auto-immune disease. I went from 299-245 during the past 6 months and I have felt so good, except of course the Lupus & pleurisy. Good Luck to everyone.

[Kat Crowder 34]

I'm approved thru BCBSIL. Their approval was easy. The problem was I had to get approved thru an outside agency because my insurance is thru the city of chicago and they have their on guidelines. It took a week for an approval that should have only taken 2 days. I called every day for 4 days and finally on Friday I talked to the the nurse. It took her all of 1.5 min to look over my paperwork and say she would send it on to the doctors. My approval came thru on Tuesday!!!

How awesome for you! I'm having a heck of a time with the insurance people at my surgeon's office.

[MinaT 669]

How awesome for you! I'm having a heck of a time with the insurance people at my surgeon's office.

Do you have BCBSIL?

[Kat Crowder 34]

Do you have BCBSIL?

Yep, I do. However, the office insisted on putting me through with diabetes and sleep apnea as my two official comorbidities, when I told them I didn't have diabetes, I had prediabetes, and my comorbidities were sleep apnea and dyslipidemia. Also, they didn't bother getting supporting information from my regular doctors. So, I've been denied and they're going to appeal, and I've insisted on them getting all my medical records to prove things.

[MinaT 669]

Kat, I'm so sorry you were denied the first time. I would travel to all my docs, get supporting documentation, have surgeon fax it with the appeal. Give it a day then call. I heard if you follow up with calls, it helps. Did you call BCBSIL yourself or were you told by the surgeon? How long did it take them to deny it?

Yikes, now I'm getting more nervous. They just put mine in Friday. I have sleep apnea, I'm victoza shots for diabetes, etc. I hope they got everything right. I'm worried because I have been diagnosed with Lupus and a few weeks ago I had to go to the hospital for pleurisy. I wish you the best of luck. Please let me know when your approval comes through!

[beautifulnewme2012 164]

I have BCBSIL and got approved super fast. Word of advice though...call BCBSIL just to verify they received the request for approval. It sits in the inbox till someone notices its there unless you call, then they fish for it right away.

[Kat Crowder 34]

Thanks, everyone - raindrop, I totally didn't mean to hijack your "yay, I'm approved!!" thread! I did call BCBS after the first submission to ask a question, and they responded to the submission with a request for more info, and all the office sent was a letter from my primary care physician, and the "attestation from the surgeon" that I've been properly educated. The denial letter came back saying that they still hadn't proven the medical necessity according to the guidelines and that they'd failed to submit the proper surgeon's attestation. That gives me little faith in the insurance department, because it's fairly straightforward to tell if you have a surgeon's attestation to certain things. I can see an honest difference of opinion between the insurance and my doctor as to whether sufficient other medical management of my comorbidities has been tried, but attesting to something is attesting to something.

MinaT, I'll let you know how things go, and you do the same to me!

-Kat

[MinaT 669]

Raindrop, so happy you were approved superfast and please keep us updated. I'm sorry your thread was a bit highjacked, but it's nice to hear stories from people that have BCBSIL. Have you scheduled your sleeve yet? What doctor are you going through? I am in Northern Indiana also and I am going through Dr. Paul Stanish St. Mary's/Community Hospital in Munster. I wish you the best of luck.

Kat, I can imagine how upsetting this must be for you after the six month pre-diet, psych eval, seminar, nutritional classes etc. that we have had to go through. Every day waiting to hear whether or not you get an approval seems like eternity. I hope something good happens for you this week.