Blue Cross 6 month wait !

[janie3867 0]

I have Bcbs of alabama....they require you to attend a 6 month physician monitored program for 6 months (7 total visits)......Get this...

Last visit on Dec 4th ... I have everything lined up to get approval/deny letter....but they want 3 years prior weights......guess what? I don't HAVE proof of 3 years prior weight. Just 2006 and 2003 - NOTHING from 2004 or 2005. Has anyone had this issue??? Please help if you have. i do not want this to be the reason for me not getting the surgery

[dynofan 0]

I got assistance from Walter Lindstrom at ObesityLaw.com. It took 2 years of litigation, but it got done!

[pippinje 0]

I have Bcbs of alabama....they require you to attend a 6 month physician monitored program for 6 months (7 total visits)......Get this...

Last visit on Dec 4th ... I have everything lined up to get approval/deny letter....but they want 3 years prior weights......guess what? I don't HAVE proof of 3 years prior weight. Just 2006 and 2003 - NOTHING from 2004 or 2005. Has anyone had this issue??? Please help if you have. i do not want this to be the reason for me not getting the surgery

You may want to check with the insurance company to confirm if they need 3 consecutive years. Does 2007 count as a year? What about 2002? Just a thought.

[janie3867 0]

I talked to the insurance specialist at my surgeons office. She said that they will take pictures if she puts dates on them. Also, she DID say we could count 2007 since I started the program in June. I only have to find something for 2005 now, since we have 2006 and 2007 but if I can't find 2005, we can find pictures

[pippinje 0]

Awesome.:clap2::clap2::clap2:

[kaninag 35]

going thru the same thing...will finish my 6mo dec 14...did you go to an obgyn...they will accept those weights as well.

I was told get as many years of weight that you can...also...make sure that with your month weight loss program they provide detailed notes on each visit...including changes in your weight...and what weight loss program you are following...they are really picky.

[jacole1820 0]

hi. i have a suggestion for you. i got all my 5 year history from all sorts of docs. everytime i went to urgent care, any doctor. just think of any kind of doctor you have ever gone to in the past 5 years or so. hope this helps.

[klassicant 0]

I have Bcbs of alabama....they require you to attend a 6 month physician monitored program for 6 months (7 total visits)......Get this...

I have BC/BS of Iowa. I had the Dr. send in my info. The girl who sent it in was new as the other had just quit. I was rejected because I had not documented everything for the past 3 years.

I then got EVERYTHING together that I had done including weight watchers, Dr. visits where I had talked about weight loss. Exercises places where I had talked about weight loss - copies where I had paid weight watchers and copies of hospital records where I had been advised to lose weight.

The document was over 200 pages long. I had it bound and sent in. They approved me withing 1 1/2 weeks. Had I known this in the beginning I would have done it before. The whole process put me back almost 2-3 months because that clerk hadn't checked out everything before she sent it in.!!!!!

My surgery date is Jan. 10. What I have gotten out of this is that BC/BS will find ANY REASON NOT TO PAY. Although I had talked with them many times - I called everyday once my things were sent and then everyday when it all was appealed. The day before they approved - I called and said that I would take it to or state insurance commission if I needed to and get a lawyer involved if I needed to.

With the growing obesity rate in the US and BC/BS advertising that they will cover the surgery (something that I checked out thoroughly before I started on this journey) I do not know why they make it so hard.

If there is anything at all that you did in the way of dieting I would submit it. The 6 month thing is required. I had gone to a weight clinic at the Unviersity of Iowa, but you should be able to have your Dr. follow you on this diet over the next few months.

I do know - at least here in Iowa that they have really cut down on approvals over the past few months. I also think it depends on who you get at BC/BS reviewing your case. I never did get past the customer desk. They won't let you talk with anyone in review. I also had my Dr's office call and then I found out where to send everything if I was denied again - the state insurance commission. I also wrote a letter outlining why I needed the surgery - comorbidities and such.

Good Luck.