BCBS IL DENIED TOO MANY STRESSORS [emoji20]

[dcole007 21]

I am soooo upset. BCBS of IL denied me because of my therapist report. They said I have too many stressors. My therapist put some inaccurate information. His wording was all wrong. I have a copy of the report and I am not happy. Has anyone ever dealt with this and anyone have information in how or what I can do about appealing this? I'm not sure if I should just get a new psychological evaluation or if that would even work. I've been seeing my therapist and I feel like he is biased and I just should not have had him do it in the first place.

Best wishes!

Dotty Cole

[Lannie 135]

Can your Bariatric center advise? Have you asked the insurance if you can resubmit with a new eval?

Good luck

[dcole007 21]

Can your Bariatric center advise? Have you asked the insurance if you can resubmit with a new eval?
Good luck

So after talking to my therapist, doctors office and insurance company the first thing is my therapist that did my evaluation is going to do a peer to peer and explain how he miscommunicated information. Tomorrow I am scheduling a new psych evaluation with a non biased doc that specializes in bariatric psych evaluations and my docs office will use it to appeal. My therapist just did terrible. He was very apologetic today and ever and told me he was so sorry for the miscommunication. So I am sensing no him an email in the morning so he can fix this. I only get 2 appeals so the peer to peer doesn't count as one. I was trying to get everything done quickly to get it submitted to insurance and my gut told me to just go to the psychologist my doctors office recommended. When will I start listening to my gut!!! Uughh


Best wishes!

Dotty Cole

[TCurry 1]

My husband works for AT&T we have BCBSIL as well and I am about to start the process to try and have my weight loss surgery covered. I hope your appeal goes well. I am praying praying they cover mine. It's my last option I have tried everything else under the sun.

[dcole007 21]

My husband works for AT&T we have BCBSIL as well and I am about to start the process to try and have my weight loss surgery covered. I hope your appeal goes well. I am praying praying they cover mine. It's my last option I have tried everything else under the sun.

It really is an easy process with an easy approval if you meet the requirements, 40 BMI or above, any chronic conditions, and a psych evaluation. They have you do the preop blood work and ekg, and then submit. When I went for my initial visit I saw the nutritionist and that was the only time I had to see her. If my therapist wouldn't have did the crazy job on the letter I would already have a surgery date. Just irritated because I already met my out of pocket so everything would be at 100% if I have it this year. But it's probably not going to be until next year at this rate.


Best wishes!

Dotty Cole

[TCurry 1]

It really is an easy process with an easy approval if you meet the requirements, 40 BMI or above, any chronic conditions, and a psych evaluation. They have you do the preop blood work and ekg, and then submit. When I went for my initial visit I saw the nutritionist and that was the only time I had to see her. If my therapist wouldn't have did the crazy job on the letter I would already have a surgery date. Just irritated because I already met my out of pocket so everything would be at 100% if I have it this year. But it's probably not going to be until next year at this rate.


Best wishes!

Dotty Cole

Thanks. I was hoping to have it by end of year as well since we had met deductible but looking like if approved will be in early 2018. I go for consult on Wednesday. Keep me updated how yours goes. My surgeons office hasn't dealt to much with
our insurance before. Did you have to find your own psychiatrist to do evaluation?

[TCurry 1]

Hey checking in to see how your process is going? I just got my approval today! Hope all is going good with insurance! Best of wishes