Looking for others who have dealt with denial from Blue Cross

[Christine_California 0]

I have Anthem Blue Cross, specifically. I was denied because I haven't had a 6-month physician supervised weight loss effort and determination of my compliance with it. I have been on several vaguely physician supervised (Phen-Fen long ago, NutriSystem, Weight Watchers, etc.) diets.

Has anyone gotten around the requirement of having to go through a physician-supervised 6-month program before being considered for the band? I have plenty of medical complications from my weight so I'm surprised I was denied.

[Bobbie155 0]

Hello,

I have Blue Cross of Pennsylvania and I had to have 6 months of supervision by my physician. If it is in your plan that you need it then you have to have it no matter what list of medical problems you have. So call your Doctor tomorrow and make an appointment for you 1st of 6 months.

[TQUAD64 9]

I had to complete the 6-month diet as well even though I had been on plenty of primary care supervised diets, including some that included phen-phen. I have Blue Cross.

[Mrsace13 0]

Mine is BCBS PPO OH and it does not say that I have to do the 6 months but I was denied today for not having enough medical issues I guess. We should find out why tomorrow so I can learn how to start the appeal.

If your plan states you need to do the 6 months, you may not have anyway around it. Good luck.

[texasweb 0]

I have Anthem Blue Cross, specifically. I was denied because I haven't had a 6-month physician supervised weight loss effort and determination of my compliance with it. I have been on several vaguely physician supervised (Phen-Fen long ago, NutriSystem, Weight Watchers, etc.) diets.

Has anyone gotten around the requirement of having to go through a physician-supervised 6-month program before being considered for the band? I have plenty of medical complications from my weight so I'm surprised I was denied.

Do you have Anthem Blue HMO or PPO?

I read the docs and do not see anything for 6 months diet on the PPO. I called them before I got the docs and they didn't say anything about the 6 months supervised diet either. They sent in for approval and the only thing they said that I needed for approval was a visit with the nutrionist.