BCBS IL Submission

Well my attorney finally sent it my submission for approval of GBS. I have BCBSIL ppo. Last year I tried and was denied because I didn't complete a 12 month medically supervised diet. Several months after my rejection I stated my diet. I followed it for 13 month just to be sure. I lost a little in the early months but when I completed the program I actually weighed more that when I started. What a B**ch. After reading about all the trouble people have had with BCBS I decided to hire a Lawyer to fight for me. I figured the small fee they charge is worth it. I received a copy of the letter that the attorney sent along with my info and I was surprised to see how detailed it was. It is actually 7 pages long. I have been looking forward to being on the loosing side for 4 years now. Well actually I have wished to be on the other side for most of my life but I have been researching the surgery for the last 4 years. I have to admit that I am a little scared that down the road that I will slip into my old ways but I try not to think of that to often. I have several friends who have had the surgery and I find that they will keep me in check. I guess all I can do for now is sit back and wait. I will be calling BCBS daily until I hear something. I am so glad that I have found this site. I have learned a lot for all of you here. I hope to see you guys and gals on the other side soon... Laterz Mike

Mike - I just wanted to wish you lots of luck in your approval process. It sounds like you have travelled a very long road already. I hope the end is in site for you soon!!! Good luck and let us know when you are approved!!! Nancy

Hey Mike ... I hope this means you'll be on your way soon! What an ordeal!! Definitely keep us posted. Best wishes to ya (and fingers crossed for a speedy approval), Karyn

Dear Mike: You may have already heard something by now.... I was denied initially for no 12 month diet (like I hadn't "dieted" for years), so I began the "official" diet last December. At the end of September, I learned that BCBS of IL has changed that requirement to 6 months. I sent my records from my pcp regarding the diet attempt to the same department where the denial came from and was approved a week later. You should be fine and on your way soon, especially with a lawyer! Good luck! Dawn

Mike one tip my attorney gave me when filing the appeals for my husband was that when Personal Care PPO offered up a third party reviewer. Make sure that this is the final stop if they deny you. Make sure that you always have an appeal option. Secondly my attorney also said that if this last letter that we sent got us another denial that i should contact my senator so that he could have a legal liason talk with the Illinois Dept. Of Insurance. Every time I sent an appeal letter I sent a copy to the Illinois Department of Professional Regulation they are the ones that review Insurance Companies and their claims for their validity. Please let me know what you find out. It took us 5 appeal letters to get things approved so don't give up.

Hi Mike, I was just wondering how it is going, I also have been denied, and just am beside myself, I have bcbs ppo il too, and was wondering if it's worth hiring a lawyer, I'm with you, I'd rather have someone else fight the battle, my denial sez BECAUSE THERE IS LIMITED DOCUMENTATION OF ACTIVE PARTICIPATION IN A COMPREHENSVE NON-SURGICAL WEIGHT MANAGEMENT PROGRAM' tho I have been going to the Wellness Center for almost 9 months, and it only requires 6 months, I've called them, and no one seems to be able to tell me, what is missing??? I sure hope you will be on the LOSING side soon, the waiting, thats the hardest. Take Care, Mina GO BEARS!!!!!!!!!!