For those approved by insurance - please answer

I have been approved for banding, but my doctor and I still think VSG is the way to go.  I just got my letter of denial from our Medical Review doc at BCBS of Alabama (my employer).  Please respond with the name of any payers who approved the procedure.  I need ammunition to go back at them again.

Thanks.

I would tell u to continue to fight. I was told by everyone at the surgeons office told me that the  sleeve was not going to be approved by aetna. Guess what i was approved. Be encouraged

Robert, I was approved through BCBS of New Mexico.  Granted, my surgeon had to jump through a few hoops but, never the less, it was approved.  PM me and I'll give you a "loop hole" that may work for you.

Katherine

I have been approve by BCBS of Ga.The doctor told me there was two ways to get  a fast approval from them. Based on your BMI if it is high enough they will approve the two step DS procedure with the doc doing the sleeve first. Secondly the will approve the sleeve if the doc write it up as a VGB where he do the sleeve procedure and put a band to make a small pouch around the top of the sleeve. But you can appeal and mayb that will be easier and get approval that way. Good Luck

I know we don't approve the DS at all, so I don't think I can go that route.

The Blue Cross list I compiled for my appeal was

Blue Cross Blue Shield Access+, California

Anthem Blue Cross Blue Shield, California

Empire Blue Cross, California

Blue Cross of Idaho

Carefirst Blue Cross Blue Shield PPO of Maryland

Blue Cross Blue Shield, Michigan

Blue Cross Blue Shield, Nebraska

Blue Cross Blue Shield, Tennesee

Carefirst Blue Cross Blue Shield Federal of Virginia

 

I also know of two individuals who won their case on appeal to have Medicare pay for VSG.

 

I heard my appeal decision was mailed today but they won't tell me what it is.  Kind of sounds like denial again.

I have BCBS Federal Employee of Louisiana, and I was approved first time.  BMI 46, no co-morbidities, just joint problems and pain.