BC/BS of IL. runaround

[Northern Mist 2]

Ok, I have been going through this for a little better than a year now and am sick to death of playing BC/BS of IL. games. I was denied the first time because they said my doctor wasn't specific enough in her notes about my 6 month diet and she didn't put her signature on a required 5 year history form - It had the letter head and was included in the packet of information, but it wasn't signed.

I went through another 6 months of dieting and my doctor writing a book every time I seen her and she signed the 5 year form only to submit everything (once again) on June 2nd and be told on June 18th that it's still sitting at BC/BS and "they" are not sure why it hasn't been forwarded to the review board. I called today to check to see where the file was at - A very nice and perky rep. says, "Wow, you've been doing this for over a year now." - I gritted my teeth and nicely said, "Yes I have, please check on things and let me know where my file is and if someone has deemed this procedure medically necessary, thanks." She put me on hold forever.... (I admit I took this as a positive sign) only to tell me, "Yes someone has it but they're on vacation until the end of the week." AHHHHH..... I am so frustrated!

Thanks for letting me vent once again.

[Tamihott 0]

My stuff goes out this week to BC BS illinois and boy oh boy I just can't wait to see what they say. I am sure the first attemp will not be successful. They drive me batty and I hear they are one of the toughest insurances to get an approval from. I wish you and me luck.

[debkeversole 0]

that's who may insurance is with too....they told me they wouldn't pay for anything bariatric:confused: :smile2: it's through walmart(DH works for the Distribution Center) any one have any knowledge of it???????

[smith5jm 0]

I also got the run around with BCBS of Il. Did everything they told me to do and twice they have denied me again even after appeal I'm fed up they win I'm going self pay they do this on purpose they just don't want to pay!!!!

[debkeversole 0]

I also got the run around with BCBS of Il. Did everything they told me to do and twice they have denied me again even after appeal I'm fed up they win I'm going self pay they do this on purpose they just don't want to pay!!!!

:thumbup:

i totally understand

[Northern Mist 2]

I got the news yesterday I was denied once again and for the same reason - lack of a 6 month supervised diet. I have turned in two different 6 month clinically supervised diets, followed the excersize and nutrition advise on both, lost weight on both and they still deny me. I'm not giving up because I have been on this insurance for 14 years and have never used it beyond once or twice a year. No surgeries or major medical expenses (besides having my two kids) - it's just the point now.

[gigim 8]

Hey Northern Mist...I have bcbs of Il..And I was denied After giving them 36 pages of history and diets from Medical Weight loss(Like weight watches).And a 2pages letter from my pcp...I am going to try this until the cows come home...I have been with this company from 20+years.No major surgeries or anything....I will continue until they approve me...They will be sick of me...Good Luck

[mstrina27 0]

Wow.... u know it is bad when they act as if they can't give the necessary cases to someone that is actually working..... I understand your frustration......I'm getting pissed off for you... Hopefully when that person returns they will be well rested and will put approved on it.... to get thru all of the paper work on the desk... Some people can be such pains in the azz..

[LISAMARIE1158 0]

l have B/C B/S Federal..my paperwork was submitted over a week ago and l'm waiting to hear..a call to Blue Cross and they told me to call them every monday unttil l get my approval..l was told by them that the approve 99%, yet l was also told that they were very difficult to deal with..no problem yet...ls is possible for you all to change companies for you insurance? l am prepared to change in January if l don't approved. Funny how the different plans of Blue Cross are so different. lm in Mass and no companies here require a 6 months weight loss program...

[GinaJ 2]

I also had everything required and was denied by BCBS IL. I turned my paperwork over to Obesity Law, and hope they have better success than I did dealing with them.

[Northern Mist 2]

Sounds like they have a million different plans and divisions. Why is it some people have to do a six month diet and some don't? I thought the whole point of the diet was to see if you could adhere to a diet plan etc... Do they think some of us (based on geography or where we work??) are trustworthy and some of us are not? Who knows.

[rgjujitsu 0]

Do you guys have bcbs hmo or ppo?

[Tamihott 0]

No surprise but I was denied today by bc illinois. I tried to get a good reason as to why and they say lack of documentation on the 6 month diet and missing one of the 5 years obesity records. I am getting some more records together right now, including a detailed summary from my Pcp about my 6 mo diet and a letter from the psychologist that is more detailed. I think the person at my surgeons office, is just not a cheer leader for me right now and I will submit all the info and do the leg work myself. I will continue until there is no hope left. Good luck everyone.

[rgjujitsu 0]

I am submitting my paperwork next week you guys are making me nervous I won't be able to sleep tonight. Do you all have bcbsil ppo or hmo?

[Tamihott 0]

I have Bc/BS illinois PPO