kaynicole 3 Posted March 11, 2015 I have highmark blue cross blue shield and they have denied my claim due 6 months being insufficient. Meaning my policy states 6 months supervised exercise to be tracked which I did. I've even loss 13 pounds because I was staying on track with going to the gym and eating healthy. Not sure if anyone one else had this issue with how to track the exercise requirement but I was told to just document it. Share this post Link to post Share on other sites
requiem 1 Posted March 11, 2015 How is your plan benefit stated/worded? My plan says it has to be a physician supervised weightloss program. I have to go to the doctor each month to have those efforts recorded. I'm in the midst of that process right now. The documentation has to come from the doctor's office. Is that what your insurance is saying to you? Share this post Link to post Share on other sites
Crosby 303 Posted March 11, 2015 How is your plan benefit stated/worded? My plan says it has to be a physician supervised weightloss program. I have to go to the doctor each month to have those efforts recorded. I'm in the midst of that process right now. The documentation has to come from the doctor's office. Is that what your insurance is saying to you? This was the same for me. The insurance company should advise you to the specific reasons for denial Share this post Link to post Share on other sites
Crosby 303 Posted March 11, 2015 How is your plan benefit stated/worded? My plan says it has to be a physician supervised weightloss program. I have to go to the doctor each month to have those efforts recorded. I'm in the midst of that process right now. The documentation has to come from the doctor's office. Is that what your insurance is saying to you? This is how mine was. The insurance company should be able to tell you what the specific problem was. Share this post Link to post Share on other sites
kaynicole 3 Posted March 11, 2015 Yes my insurance said the same thing. And we followed all of the instructions. So my Dr will be doing a appeal because he say everything was done right he submitted another claim to the same company and its was approved. Share this post Link to post Share on other sites
requiem 1 Posted March 11, 2015 Yes my insurance said the same thing. And we followed all of the instructions. So my Dr will be doing a appeal because he say everything was done right he submitted another claim to the same company and its was approved. Oh, that's good. I thought you meant you just kept track on your own. Good luck with the insurance. Share this post Link to post Share on other sites
mamafine23 101 Posted March 15, 2015 Hi, I'm sorry that they denied you and maybe I can help you with your questions...did you go 6 consecutive months ? What is your height and current weight ? What office are you going through ? Share this post Link to post Share on other sites
TMG1980TMG 136 Posted March 17, 2015 Did your surgeon submit your appeal? I am paranoid because I have Highmark BCBS too-- I know every policy is different but still..... Good luck with your appeal!! Share this post Link to post Share on other sites
Cupcake 801 Posted March 17, 2015 I agree with the above statements I would appeal it goof luck and don't give up. Share this post Link to post Share on other sites
kaynicole 3 Posted March 17, 2015 Yes my insurance rep already submitted my appeal I should have a decision by this week I plan on calling them Wednesday for a status update. Share this post Link to post Share on other sites
kaynicole 3 Posted March 17, 2015 She also advised me that she could submit 2 of the same claims at the same time and one would go through just fine and the other will get delayed for some reason. Share this post Link to post Share on other sites
kaynicole 3 Posted March 18, 2015 I got my approval first submission dat 03/04/2015 approval as of 03/17/2015???? Share this post Link to post Share on other sites