xpost If you have fed bcbs and were denied due to not losing during the now required 3 mos...

crystal W.
on 4/15/11 6:00 am - east liverpool, OH
Yes this has been posted several times, but here is the thing.  I lost 10 lbs in a week using an all liquid diet.  Yesterday my dtr went into labor and I was at the hospital all day and did not have my usual protein shakes throughout the day.  I had an admittedly high calorie bacon egg and cheese croissant in the morning and 6 unbreaded chicken wings around 7 pm, high calorie also, I'm sure.

This morning, I was up 2 lbs.  I can't fathom how this can be, but now I really want to just make the surgeon's office submit my paper work and get the ball rolling. 

I would really like to tell them there should be no problem because it doesn't read anywhere in the plan brochure that loss is required, only participation for 3 months.

PLEASE, PLEASE, PLEASE, let me know if you were denied this year, under the new rules, for gaining or not losing during the supervised diet. 

Thanks so much

Crystal
rural_carrier
on 4/15/11 7:09 am - Florissant, MO
 All it requires is the 3 month supervised diet.  It is not required that you lose during this supervised diet and it doesn't matter if you gain weight either.  I was approved, my son was approved, and as of yesterday my husband was approved. When the dr.'s office i8s ready to submit the paperwork have them put "urgent" on the first page and then they will usually fax it to the insurance.  After they fax it wait 2 days and then start calling the insurance.  They will probably say they didn't receive it yet when you call--don't freak out--they haven't got it into the system yet.  The next day call and if there isn't a verdict yet call the next day.   My dr.'s office submitted the paperwork on a Thursday evening and the following Wednesday morning the surgery was approved.  You need to be your own advocate.  I have been through this process with three people plus myself also.
Good luck!
Joann

 
  
crystal W.
on 4/15/11 9:52 am - east liverpool, OH
So how did your husband do on the diet?  I'm just so hung up on being 11 lbs heavier after the diet and I know ins companies are looking for any reason to deny the surgery.
rural_carrier
on 4/15/11 9:58 am - Florissant, MO
 He gained 13 pounds.  Why would they deny you surgery for gaining weight?  That is why you need the surgery.
Joann

 
  
crystal W.
on 4/15/11 10:20 am - east liverpool, OH
Thank you!!!  That's what I was thinking but I just didn't know what to do.  I've been struggling trying to get below 233.  Then to see a gain this morning was such a sucker punch after an awesome day watching that beautiful boy come into the world
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