BCBS Federal Denied

[Mamamac5 3]

So, I met every bit of criteria for the gastric sleeve. Did 4 months worth of required tasks and submitted for approval. Unfortunately, I had smoked but stopped a year ago. Apparently, by mistake, I checked I was smoking when I thought it said "have you smoked". There are no medical records of my smoking or stopping so now BC has denied me with the opinion that I have smoked in 6 months. I have written my own letter of appeal since I have no doctor proof and explained the timing and situation. Does anyone have any experience with this? Is there a chance at all that BCBS will take into account my letter? OR AM I JUST OUT OF LUCK? One more question....if they can take my word that I was honest and said I did smoke, why can't they take my word that I have stopped.

[Christinamo7 4,042]

You should be able to correct and resubmit. They may want a blood check for nicotine. Get with your clinic and let us know what happens.

Sent from my iPhone using the BariatricPal App

[kmorri 1,689]

I agree you should be able to appeal the decision .....your letter is a good plan.....you may also want to call them. Good luck and keep us informed.

[Mamamac5 3]

Thanks for your ideas and support. Will keep you posted. congrats to you guys on your success...hoping to join you soon.