Bcbs Alabama Insurance

[alisha29 22]

Question...I have bcbs Alabama insurance. I have completed all of the steps for submitting my request for surgery. I did not have 3 years of medical records but used dates photographs and the past 18 months of medical history. My insurance denied my claim within a day of my request. My surgeons office says this is normal when they submit a claim with photographs but that they resubmit and get the approval. I am freaking out here with all the time and money I have already invested! Has anyone else ever had this experience or can share what your experience was with my same insurance? Any info would be helpful. Now I am wondering if I need a plan b and try for self pay in Mexico. Roughly how much is this option? Any advice and support will be helpful! It took several months to come to terms with having the surgery and the 7 more to meet insurance requirements. I have too much invested emotionally and financially for my journey to end here.

Blessings to all!

[valdostaGA 149]

I have them and was approved in a week on the first try. As long as u meet all of the requirements they usually approve. Do u have any ER, walk in clinics or anything that u went to in the past. What's your bmi?

[alisha29 22]

No, I did not have insurance and did not go to the doctor. My current bmi is 46 and other than being fat, I am pretty healthy according to lab work. I don't feel healthy at all though! I am tired all of the time, my body aches, and I don't enjoy doing things I once loved. Did you send in pictures or did you have weight records?

[valdostaGA 149]

I had medical records. Do u snore when u sleep? If so u make could get your doctor to do a sleep study.

[alabamaorthogirl 9]

I haven't submitted yet. One month to go. I'm having problems with the 3 yr medical history too. I have same insurance as you. I hope you do get accepted. Please keep us posted. Good luck. By the way I did look into the mexico thing. Can be as cheap as 5000 or I was looking at Alvarez and he was 8700. Still hoping I get approved with insurance before I pay out of pocket.

[alisha29 22]

I hear ya! Hoping to get approval. I will keep you posted on my status. Best wishes to you

[bamagirl 31]

I also have BCBS Alabama. Submitted to insurance today. BMI 42, not for three years though. Three year history show BMI from 38-42. Mainly thanks to dieting. I will let you know their response as soon as I hear.

[KickRocks 163]

Hi, I am going through the same thing right now with BCBS OF AL. I just want to cry. I have not been to the Dr since 2007! Even though I have been overweight since 99 they need recent records! I don't understand why it matters. I don't know what to do now. Let me know how it goes and good luck to everyone!

[alabamaorthogirl 9]

It is so frustrating to go through all this, I have cried so many times. Once I broke down at the drs office. So embarrassing. You need to appeal. Check out exactly what your policy says. Mine says you can substitute dated pictures for actual weights. They might have denied first off but depending on what policy says you might be able to fight it and eventually get approved. I wish you the best and hope you and I both get approved. Keep your head up and don't give up. We are fighting for our life back : )

[KickRocks 163]

Mine says the same thing about the pictures. I decided to change offices for my surgeon today. (Same surgeon but different office and hospital). After talking to my new insurance coordinator i feel a lot better. My old insurance coordinator flat out told me if I didn’t have the last 3 years they would not approve me EVEN THOUGH I have completed all the other requirements. I was heartbroken! I called the insurance company and they told me to have them send in a pre-determination in but she just kept saying they will still deny. She didn’t offer any help and didn’t care at all! She was hell bent on not sending anything in to the insurance company. So I was never denied per say cause SHE NEVER SENT IN ANYTHING! SMH

So, I decided to call the other office and speak to them. It was like night and day! She told me that she would help me fight. That we will get all the medical history I have and use 3 years of recent pictures and make sure that we have a strong case. She says even if they deny the first time the Dr can do a peer to peer and lay out all the facts. So we shall see. I just can’t wait to get this all over with.

[alabamaorthogirl 9]

I feel the same way about my insurance lady. They don't have a coordinator. The insurance lady made it clear to me that I am on my own really making sure I get approved. I don't think she would try and fight for my approval. I like the surgeon but office is frustrating. We will see what happens. If it doesn't work I have thought of trying another surgeons office that seems like everyone gets approved through. I'm not going to give up. It has been hell the past 5 months. Can't wait to submit. I really hope you get approved. Keep me posted and good luck!

[slimshadychick 12]

I am double covered 2 bcbsal. My primary ins. Has a bariatric exclusion on it, but my secondary will cover wls. I tried to have the lap band in "09" and the ins. Lady there said I would have to drop my primary ins. In order for them to have my wls approved. I did that and ended up getting denied anyway ( thank God). My husband changed jobs so I was able to pick my ins. Back up and now getting ready to submit info to bcbs friday and not wanting anything to prolong my time I asked the ins lady at this office about it and she said I wouldn't have to drop my primary ins. They would submit to the primary and let them deny it and then file to the secondary ins. And they SHOULD pick it up.....Idk and I don't like not knowing. Anybody have clue on this???? I did have 1 doctors visit denied because of a wl code was used as the first Dx?!?!?!

[alisha29 22]

I am STILL waiting....so frustrating! Anyone else hear anything yet?

[bamagirl 31]

Nope! I'm still playing the waiting game too! I hope we all get good news soon!

[valdostaGA 149]

Praying for u all! I have this same insurance and only had it since january with no other coverage prior.they approved mine and I was sleeved Oct 5th. Don't give up if u have a coordinator that's not doing her job find another office! That's what I had to do. I changed surgeons at the last of everything and they got me approved! Blessu all<3