Denied by BCBS IL

[GoneFishin 0]

I received the letter of rejection today citing the 6 mo. non-surgical weight loss program as the reason. I did WeightWatchers and lost 17 lbs. My surgeon has all the documentation, so I will check it out further tomorrow. Maybe it just didn't get sent in. Hope it can be salvaged by my 3/03/09 surgery date. If I lose that, it's about a 6 mo. wait for a new date. Can't say I didn't expect this, given what I have read and heard about BCBS IL. I am committed to this surgery and will not relent. Whatever I must do, I will.

I'll keep you posted...Dan

[plain 12]

Good luck, Dan. From what I've read, it's not uncommon for insurances to first deny, and then approve on appeal. Hang in there.

[GoneFishin 0]

Thank you. I called BCBS IL today. I told the "customer care" person that I was recording the conversation for accuracy. She pulled my record and explained that I had not completed the 6 mo. medically supervised, non surgical weight loss program to their satisfaction. I pointed out that I had done WeightWatchers for the required time and had lost 16 lbs. I was told that it must also be accompanied my records from my PCP showing that I had been counseled in exercise, calorie reduction, behavioral modification, etc. I pointed out that none of their info specified that. "Sorry, that's the way it is." Happily, my PCP's nurse is a fighter. She said "I can fix that." and said she would fax what they need tomorrow. Maybe 3/03/09 will still be my magic day! Thanks again. BTW, good results on your part. Way to go!

Dan.

[lose2regainme 0]

Thank you. I called BCBS IL today. I told the "customer care" person that I was recording the conversation for accuracy. She pulled my record and explained that I had not completed the 6 mo. medically supervised, non surgical weight loss program to their satisfaction. I pointed out that I had done WeightWatchers for the required time and had lost 16 lbs. I was told that it must also be accompanied my records from my PCP showing that I had been counseled in exercise, calorie reduction, behavioral modification, etc. I pointed out that none of their info specified that. "Sorry, that's the way it is." Happily, my PCP's nurse is a fighter. She said "I can fix that." and said she would fax what they need tomorrow. Maybe 3/03/09 will still be my magic day! Thanks again. BTW, good results on your part. Way to go!

Dan.

I am in the same position with BCBS-IL. My case is with an attorney advocate. How is your approval going?:tongue2:

[texasweb 0]

I received the letter of rejection today citing the 6 mo. non-surgical weight loss program as the reason. I did WeightWatchers and lost 17 lbs. My surgeon has all the documentation, so I will check it out further tomorrow. Maybe it just didn't get sent in. Hope it can be salvaged by my 3/03/09 surgery date. If I lose that, it's about a 6 mo. wait for a new date. Can't say I didn't expect this, given what I have read and heard about BCBS IL. I am committed to this surgery and will not relent. Whatever I must do, I will.

I'll keep you posted...Dan

I had BCBS-IL until June 2008. My employer switched to Anthem BC of CA. I was approved with no requirement for a supervised weight loss program with Anthem. I am so happy that my employer switched. I hope everything goes well.

[GoneFishin 0]

Thanks for the reminder. I need to call them today to make sure they received my appeal, which I mailed certified with a return signature of verification. Might wait to see if that comes back in todays mail. Dan.