Regence Blue Shield-Wash. State

coatham · March 1, 2007

Hi Everyone,

I have wonderful news with a bit of a spin! I started the process to get approved back in October 2006. At the time my insurance didn't cover LAP Band, it only covered GBP. And I asked if they planned on coving it in teh future, but the lady said they didn't know.

After meeting with Dr. Earl Fox, I decided I would pay for it and then deal with my insurance. So, on December 22nd I had LAP Band at Auburn Regional Medical Center. I'm doing great!

Now, it's March 1st and on February 26th I got an approval letter from my insurance company for LAP Band. Subject to all terms in the Plan, i.e. eligibility date. Well, I called my insurance company and asked when did you start covering LAP Band? January 1st, 2007!!!!:faint: A whole nine days...

So, I have called all the comapnies and people that I have already paid and asked them to send my insurance the bill. I want to know if anyone has had this happen and did you get it covered after appeals?

If anyone has any advise with regards to the appeal process, that could :help: me, I would appreciate it.

Thanks for listening!

Charlene

AudreyG · March 8, 2007

Hi!

I just read your post and maybe you can help me!

I have an interview with a company that has Regence Blue Shield of Washington....

So is what your saying that the cover it now..or...I guess I'm confused.

Please help!

I'd love some good news

coatham · March 9, 2007

Yes, as of Jan 1, 2007 my husband's plan covers LAP Band. His plan is with the Boeing Company. I don't know if each companies coverage is different or not with Regence. It's worth checking into.

Good Luck!

Charlene

AudreyG · March 9, 2007

did you have to do any supervised diets or anything of the sort?

coatham · March 11, 2007

No, Regence required only that I was 100 pounds over weight for at least the last five years. They did ask for additional documentation from the provider after everything was sumitted. They wanted 5 different chart notes, in five different years, stating weight. So, we just started looking through chart notes and found ones that where good. Like, there the doctor and I had been discussing weight or weight related problems. It really didn't take that much time for the approval. I was surprised!

Let me know if you end up with Regence and how your process goes. If you have any other questions, feel free to ask.

Charlene