Insurance Denial - WTF????!!!

Mar 22, 2011

So I have been officially denied.  This really sucks! Here is a little background.  BCBS of IL had a 3 month diet requirement, which I met.  They changed their policy on 3/15 to require a 6 month diet.  I completed the 3 months and submitted to insurance in early March, well before the 15th policy change.  BCBS of IL then denied me yesterday (3/21) because I didn't meet the new policy requirements.

According to the insurance rep, BCBS looks at the active policy requirements from the date of approval or denial, not from the date of submission, so even though I completed and submitted the 3 months of Doctor supervised visits AND I send in the paperwork before the 15th of March when they changed the policy, they are STILL making me adhere to the new policy.  I'm trying to decide if this is worth appealing or if I should just do the remaining 3 months of dieting.  What do you think? 

I'm just pissed off!  What was to stop them from holding onto my paperwork for as long as possible so that the decision hadn't been made by the time the policy changed, so that I would be automatically denied according to the terms of the new policy?  What if they decide in 2 more months to change the diet requirements to 12 months?  Like I said, I'm furious!  What would you do if you were me?

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