Blue Shield Of California Ppo

[Trcyprkr70 69]

So do I Denise.... I have some things that I need to get under my belt and I need this out of the way so I can get adjusted. KiKi my bmi is 39 and I have diabetes and high blood pressure. I'm 5'6 and weight 250. I hope mind come back soon. I have picked up 25 lbs in the last six months after losing close to 30 lbs. I just want to get the weight off and keep it off. Hope to get off the meds. The insurance paid for everything and approved right away, except for the psychologist I paid for out of pocket. I was mainly waiting for appointments. So KiKi do you have a date yet?

[helleva 22]

Kiki,

Thanks for the response. I had gestational diabetes along with sleep apnea. Glad you were approved did they contact you or did you call the insurance the next day?

Thanks,

Denise

[kiki79 2]

My insurance company called me before the doctors office called. Good luck, I am sure you will be approved.

[kiki79 2]

I have preop tomorrow and surgery is May 23

[Trcyprkr70 69]

Well good for you keep us posted. Wish you the best.

[helleva 22]

thanks for the good hope and info.. thats awesome your having your surgery soon yes, please keep us posted!

[helleva 22]

Hi,

I was just told that I have been denied! I'm so disappointed!! My coordinator I going to try and set a peer to peer and if not she will have to appeal. Just thought I'd update.

Thanks,

Denise

[SV2 57]

Hi' date='

I was just told that I have been denied! I'm so disappointed!! My coordinator I going to try and set a peer to peer and if not she will have to appeal. Just thought I'd update.

Thanks,

Denise[/quote']

Damn!!

What was the reason given for the denial?

[helleva 22]

Hi,

The reason was "not medical necessary". I don't understand. I had gestational diabetes, only have one kidney, and I have sleep apnea. I have been over weight most of my life. My father had diabetes, high blood pressure, renoplasty (spelled wrong but can lose his eye sight at any time from diabetes), kidney failure, and more from being over weight. My doctor for the past 11yrs. Recommended this procedure because he's seen my struggles and knows I'm headed down the same road as my father. I'm so sad and disappointed

Thanks for responding,

Denise

[SV2 57]

Hi' date='

The reason was "not medical necessary". I don't understand. I had gestational diabetes, only have one kidney, and I have sleep apnea. I have been over weight most of my life. My father had diabetes, high blood pressure, renoplasty (spelled wrong but can lose his eye sight at any time from diabetes), kidney failure, and more from being over weight. My doctor for the past 11yrs. Recommended this procedure because he's seen my struggles and knows I'm headed down the same road as my father. I'm so sad and disappointed

Thanks for responding,

Denise [/quote']

Gotcha.

Damn... Don't give up.

I am also a low BMI patient (just over 35), with few comorbidities. The main thing for me is that my lapband has slipped, and needs to be removed. I was hoping to have a band to sleeve revision. Maybe the insurance will figure that since the surgeon will be in there anyway, he might as well sleeve me...

I've been told BCBS PPO is among the easiest to get approved, but maybe not.

Keep us informed as to what's going on.

[helleva 22]

Hey,

I heard the exact same thing about my bcbs. I think it just depends because a lady on here had gestational diabetes and was approved just with that alone. Thanks, I don't plan on giving up. I'm hoping my physician and/or coordinator will fight with me. They really thought I was going to get approved first time around. I wish you lots of luck. It makes sense to do the procedure well taking out the band. Keep me posted and thanks again for responding to my post!

Denise

[SV2 57]

Hey' date='

I heard the exact same thing about my bcbs. I think it just depends because a lady on here had gestational diabetes and was approved just with that alone. Thanks, I don't plan on giving up. I'm hoping my physician and/or coordinator will fight with me. They really thought I was going to get approved first time around. I wish you lots of luck. It makes sense to do the procedure well taking out the band. Keep me posted and thanks again for responding to my post!

Denise [/quote']

Absolutely!

We're in this together.

[helleva 22]

Thanks SV2

means a lot! have a great day..

[Trcyprkr70 69]

Helleva, sorry to hear that, now I'm worried. Its been just over a week since my papers was submitted and I haven't heard anything. Hopefully they will get you approved soon. I don't know why some people get approved and others don't. I have so much aniexty right now.

[helleva 22]

Oh gosh I know! Its so nerve wrecking I had so much hope reading others approvals. I don't get it. Thought I'd be approved. I waited 5 days then I called my insurance. I didn't get the denial until today though. I really hope you get approved please keep me posted on your situation. Best of luck!

Denise