raec81 18 Posted January 6, 2015 My first attempt at approval was a long, disappointing headache. We submitted to BCBS and they denied it saying I didn't have a co morbid when their criteria clearly stated BMI of 40 and greater or 35 and a co morbid. At the time mine was around 50. We appealed and proved our case but they then admitted I was a candidate but denied it due to administrative error. There were no errors. The next option was a state fair hearing which we pursued to get the run around. By this time it was open enrollment so I switched to WellCare. During all of this I finished the 6 month diet because BCBS only required 3. My insurance started the 1st of January. My doctors office submitted my packet on the 5th. Yesterday! This morning we got the approval. I am beside myself right now. I go in Thursday to get a date! Share this post Link to post Share on other sites
Elode 8,093 Posted January 6, 2015 @@raec81 Awe wow what a headache! That goodness that war is over! Yay! Congratulations! I can't imagine how aggravating that must have been but the old saying is true "good things come to those who wait"!! Share this post Link to post Share on other sites
raec81 18 Posted January 6, 2015 Thank you so much! Share this post Link to post Share on other sites
Miss Mac 6,262 Posted January 6, 2015 Delay is not denial. Congratualations and kudos to you for being persistent and pro-active. Share this post Link to post Share on other sites
*Lexie* 1,486 Posted January 7, 2015 Insurance can be so frustrating. Congrats on your approval. Share this post Link to post Share on other sites
rafaelfsp89 8 Posted January 7, 2015 I feel Ur plan same thing with me and bcbs anthem horrible...now I got tufts health plan so much better Share this post Link to post Share on other sites
Msnicnic 24 Posted January 8, 2015 My first attempt at approval was a long, disappointing headache. We submitted to BCBS and they denied it saying I didn't have a co morbid when their criteria clearly stated BMI of 40 and greater or 35 and a co morbid. At the time mine was around 50. We appealed and proved our case but they then admitted I was a candidate but denied it due to administrative error. There were no errors. The next option was a state fair hearing which we pursued to get the run around. By this time it was open enrollment so I switched to WellCare. During all of this I finished the 6 month diet because BCBS only required 3. My insurance started the 1st of January. My doctors office submitted my packet on the 5th. Yesterday! This morning we got the approval. I am beside myself right now. I go in Thursday to get a date! Congrats to you!!!! So sorry you had to go through so much to get what you needed. Maybe changing insurances was for the better. Share this post Link to post Share on other sites
kyrickchick64 468 Posted January 8, 2015 Maybe we'll be sleeve sisters. I have to go in to the doctor asap Share this post Link to post Share on other sites
Msnicnic 24 Posted January 8, 2015 Maybe we'll be sleeve sisters. I have to go in to the doctor asap Yes...how about that. I'll add you and we can check up on one another. My date is set for 1/13/15. I should be nervous...huh....but I'm too excited right now. ???? Share this post Link to post Share on other sites
brandy31 32 Posted January 8, 2015 So happy for you!!!! Share this post Link to post Share on other sites
kyrickchick64 468 Posted January 8, 2015 (edited) I have to call the dr tomorrow but I still have to fight for the hernia surgery. So hopefully some time this month Edited January 8, 2015 by kyrickchick64 Share this post Link to post Share on other sites
raec81 18 Posted January 8, 2015 I have to call the dr tomorrow but I still have to fight for the hernia surgery. So hopefully some time this monthIs it the doctor or insurance fighting you on the hernia? It's just easier to do it while they already have you under. I didn't know I had one until my doctor poked around with the EGD. I think he woke it up now it's so annoying. Good luck and hopefully they quit fighting you. Share this post Link to post Share on other sites
raec81 18 Posted January 9, 2015 Got my date this evening! My surgery is scheduled for January 30th! I'm beyond excited. Share this post Link to post Share on other sites
rafaelfsp89 8 Posted January 9, 2015 I was also finally approved ! January 21...8 am sharp ! Share this post Link to post Share on other sites