BCBS INSURANCE APPROVAL

I AM CURRENTLY IN THE PROCESS OF MEETING MY REQUIREMENTS FOR BCBS TO APPROVE MY SURGERY.  THE OFFICE TOLD ME THAT TO EXPECT A DENIAL THE FIRST TIME THROUGH AND TO BE READY FOR AN APPEAL.  ANYONE GONE THROUGH THIS AND HOW DID YOU GO ABOUT GETTING THE APPROVAL?  ANY HELP WOULD BE APPRECIATED!  THANK YOU!

I have BSBC IL PPO and I was approved on the first try and with about 7 days.  So there is hope, I rememeber hearing and all the bad insurance stuff and had myself conviced I would never get approval.  So its doesnt all happend with a denial right off the bat.  

THANK YOU FOR YOUR HELP.  I'LL KEEP MY FINGERS CROSSED THAT I GET APPROVED THE FIRST TIME THROUGH.

All I can tell you is that they are VERY STRICT.  You must comply with ALL of their requirements, the way they want you to.  Make sure your doctor supervising your weight loss attempt takes very good notes.  In some cases, your surgeon can give you a form that they can fill out each month showing exactly what the insurance company wants to see.

I wish you great luck, it CAN be done in one try, but they like to be very picky.  Many times, they will deny for "missing information", but they really have it, they just didn't see it.

Keep positive thoughts and copius notes!

THANK YOU FOR YOUR HELP!

Hi!! I am actually in the exact situation as you right now. I am also using Dr. Wagner and doing the lap band procedure. I am from IL, with BCBSIL. I know that the outlook on BCBSIL is not good and they are very very strict. I can't say I am 100% convinced yet b/c I haven't gotten my final approval letter yet, but so far things are looking like they are headed in the right direction. My info was sent to BCBSIL about 2 weeks ago. About 4 days later, they called Sarah and sent me a letter that stated that I needed to complete my 6 month supervised weightloss program and they had only received 5 months up until that point. (This is true, we knew this would probably be the case, but I was not "denied", just postponed until I get my 6th month notes from my Dr, which is a Sept 2nd appt) They basically said to fax that info in when I get it and they are hopeful everything will go through after I get that completed. So like I said, I am very hopeful things will go through as it seems, but still a little apprehensive to believe it 100%. I will try to keep you updated on my progress.

What is your situation? Do you meet all their requirements, 6 months weightloss, etc? Good luck!!

p.s. Have you met with Dr Wagner yet? What do you think? I think he seemed nice, but I think the aftercare is the most telling---which from his reviews seems good. Good luck!!

Amy

It looks like I may be in good company.  Have you thought ahead to when you will schedule your surgery?  I keep looking at my schedule and wondering how to fit the demands of my work and school into this.  I have an opportunity for a trip to Las Vegas in December and think maybe I should wait until after that for the surgery but I am so anxious to get started on this.  I first researched bariatric surgery in 2003.  It has taken a long time to make this committment, but, there is no turning back now!

AMY,
  I AM IN THE 3RD MONTH OF MY SUPERVISED WEIGHT LOSS PROGRAM.  I AM DOING WEIGH****CHERS ON MY OWN AND SEEING MY PHYSICIAN EVERY MONTH.  NEXT MONTH I AM DOING MY PSYCH EVAL AND STRESS TEST.  I WANT EVERYTHING OUT OF THE WAY SO THAT WHEN BC/BS SAYS YES I AM READY TO GO. YES I HAVE MET WITH DR. WAGNER. HE SEEMS KIND OF QUIET.

I was denied the first time but then my nut wrote a letter disputing what they said was wrong and they approved in like a week. I didn't have to appeal. They asked for someone new to look at it and it worked. Just have EVERYTHING you need and good luck :)

I could have written your post.  I am going with the same surgeon and have BCBS too.  I think I am in month 4 of 6 and had my psych evaluation on Monday.  I've had the thyroid blood test, a stress test for my heart.  What I am really concerned with is my family doctor does not appear to be documenting this journey to Sara's satisfaction.

I really like Sara.  I think I went with Dr. Wagner because of his staff :)