Question:
After waiting on pins and needles
since July for an answer, I found out that I was denied by BC/BS for the RNY surgery. The reason being `not enough weight loss history`. I thought that was a joke because I gave them 25 years of weight loss history ! I guess it`s on to the step now, an appeal. It took 6 mo. to get a reply from them so I don`t expect to have ths surgery any time in the near future. Needless to say, I am not a happy camper at this point. I would appreciate any advice anyone might have for me. — Kay R. (posted on December 15, 1999)
December 15, 1999
Kay, so sorry to hear this. I hope that the appeal works out
for you. please email me i am your neighbor. I am only about
20 miles from you and would love to help out all i can. Where
are you going for surgery and you will be :). I went to btc
in ann arbor. I am alittle over 3 months post. good luck to you
and have a great holiday. I will be thinking of you
tina [email protected]
— Tina F.
December 16, 1999
I am sorry that BC/BS has given you such a hard time. I had an answer from
them in less than a week (approval) and no weight loss history was provided
at all!! What a difference!!
Is yours Highmark BC/BS. I would question why such a difference from state
to state?
— Connie H.
December 16, 1999
I waited almost 2 years before I was approved. Luckily for me I got new
insurance thru MY work that approved my surgery. During the long wait, I
would lose hope but I never gave up. Keep at it, you just never know what
the future holds. It is more than worth the fight to finally live like
"normal" people. Appeal and resubmit is my advice to you. Good
Luck, and never give up on your dreams! God Bless! Jan Terry
— Jan T.
December 16, 1999
Sorry Kay, I wrote you an email thanking you for being my angel, and now
you could use one.
I didn't have much problem with BCBS of Ill PPO. Remember I'm having my
surgery at Bariatric
Treatment Center, Ann Arbor, Michigan. I had my psych eval, and diet
history, but only 3 years
of diet history. They wrote the letter for me and they said they have lots
of experience with
getting approvals. Maybe you could try them. I know you probably want the
doctor you have chosen
already, but when I went in for my consult, I asked about approval success
with BCBS, and they
said usually it is not a problem, and in my case it was approved although
the doctor is out of
network, but that was okay too. Hang in there and email whenever you like.
I could give you some
information on BTC if you're interested.
— Rachel H.
December 16, 1999
Kay . . . I went thru much the same with bc/bs of IL ppo. Finally after 5
months I contacted the IL Dept of Ins. and was approved with in a month.
It sounds like you have MORE than enough diet history. Keep the faith.
Let me know if there is anything I can do for you.
— Mary P.
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