BCBS IL revision, Insurance, errrr!!

I am trying to be patient, I think I've been REALLY patient. It has been over 2 years since I have been dealing with my slipped/prolapsed band issues. Last year, BCBS IL denied my revision stating I needed to do the 6 month weightloss plan again. Okay, so I did that, amongst other new things. I had to switch hospitals/surgeons for the second time because that hospital cancelled their revision program. Now, hoping/thinking everything will go better now and just found out the BCBSIL denied my revision again, but lists no reason and just states to look at prior denial records. Errrr!!! So apparently now it is under verbal appeal...? I have a call into my surgeon's office for more information, so we will see. They are denying both the removal of my band and the revision to VSG. I don't understand how they can not follow through with aftercare on something they authorized me to have 4 years ago and deny the removal...I guess they are just wanting to wait until I have tons of damage and must have emergency surgery to remove? 

So frustrating and needed to vent!! Anyone experience this? I don't know how the appeal process works and what happens from there.

Thanks again.
Amy

I too have BCBS of IL. I had to fight with them on just getting approved for VSG as a first surgery. You need to call them directly. I did and found that they have a habit of reacting and not reading. They took the 6 months of dieting off as of February and even now they kept asking me where my 6 months of documents were. I had to point out to them that it was removed.

Stay on top of them and Good Luck!

Thank you. Yes, I totally agree...reacting and not reading! I think it is just easier for those people to not do their job and just to pass on it. Thanks again!

you do realize that insurance is a *business*. they are out to make money and keep money in their and their shareholders pockets,right? If they pay for anything fffor us,that is less money in their pockets.

they don't rally care about our health,we are just living breathing commoditioes for them to make money from,the less they have to pay out ,the more money they keep in their pockets.

Many companies instruct their employees to stall on approving/paying as much as possible in the hopes we will get pissed n quit trying or change jobs/insurances. That is what they are banking on...they get your premiums without having to pay out any more than is squeezed out of them for our care.

Stay on them every second,demand everything in writing,signed by somebody you can track and don't give up!

GL

Yep, so annoying. Pay this $400/mo premium, pay 100% of costs until my $3500 deductible, you would think they could live up to their end of the bargain though.

Thanks for your reply.
Amy