BCBS FEDERAL DENIED ME

THEY WERE ASKING ME TO PROVIDE PROOF THAT I DID OR COULD NOT LOSE 50% OF WEIGHT FROM MY FIRST SURGERY THE SLEEVE IN 2010. PROBLEM IS THAT I HAD THIS SURGERY DONE IN MEXICO,PAID CASH SO NO INSURANCE, I DIDNT HAVE A WAY TO DO ANY FOLLOW UPS WITH A DOCTOR, SO HOW CAN I PROVIDE PROOF OF FOLLOW UPS AFTER THE SURGERY IN 2010.. WHAT OTHER AVENUE CAN I GO THROUGH TO GET APPROVED. I JUST GOT INSURANCE IN 2012.

So it looks like they need to know what you weighed pre-op and compare it to what you weigh today.  It's a fair request.

I would hope that your surgeon in MX took a record of your weight when you had your surgery.  You can get paperwork that shows that.  Did you go to any doc at all in the last two years?  They usually record your weight whether you want them to or not.  

I never saw a doc after sleeve in 2010, i didnt have any insurance at all. I do have paperwork from mexico

You might very well be okay with that.  Just give them a call and ask if you haven't already.  Ask if that documentation is sufficient.

In addition to mx paperwork do you have any records from weightloss attempts? Maybe weigh****chers, Jenny Craig, etc?

I have a few months of off and on doc visit from a friend of mine who is a doctor, but she and i are not talking, she has doc of my weight after surgery..

Since you have insurance now, go to your pcp and explain what you goal is then ask her to document your weight loss efforts. In six months you have that done. I know it's rough waiting but 6 mos isn't that long.

So you are going to have to jump through some hoops to get what the insurance company wants.  Do it.  the DS is worth it.  Get a PCP and get your weight documented.  Get your records from Mexico.  By March or April you will have had time to document your weight and failed weightloss and can then get approved.  Do it.

I thinkk they want to see my weigh in from doc appt from after the gastric sleeve in 2010... So im assuming they want to see what i was weighing around 2010 and 2011.