Bad News-->Good News-->Who Knows?!?!?

Ok, my brain's going to explode here. I called the surgeon again yesterday and spoke to Nicia who told me the insurance packet was not sent b/c I did not have the 6 mos. weight loss attempt documentation. I explained to her that it was all there in my medical charts. She told me that it's there, but the documentation is too spiratic, in other words, I have 4 mos. consecutive and the skip two months before resuming doctor's visits again. So, all's well that ends well, right? She finally decided to send the insurance what we do have and leave it in there hands b/c she feels as though it's all there (just not in the order the ins. may want to see it). So she faxed it to the insurance who is waiting for it to send it to med.review right away. I am actually impressed with my insurance. The lady I spoke to was GREAT!!!! She advised me that as long as the documentation was there they won't be too tough on looking for the "consecutive factor". I have a lot of other supporting documentation that should cover it. So I will have an answer in about 24-48 hours. According to Nicia, if I get denied, we may be able to rectify that with a more detailed letter from my PCP. So, wish me luck and please pray for me. I have come this far and don't plan on giving up just yet, but things are so up in the air.

Duct tape. Wrap your head in duct tape, to keep it from exploding. Other than that, Good luck, I hope you get a positive response, and quickly.

You guys think that duct tape can fix anything!!!

Your insurance co. can approve it with some exceptions. I have Aetna, they were not big on the diet time line since i have so many other problems. The important thing is just what you did. Get the information to the zIns. You can also ask them to let you know if they need anything else. That way you don't get turned down and have to reapply. Keep on them - you will get there.

Nicia didn't steer me wrong with her suggestions of when to submit to the insurance company, so I'll sure keep my fingers crossed for you!! Jan

Hi Danielle, I have BC/BS and did not have ANY proof of diet. I'm sure they wouldn't send it if they didn't think it would be approved. Good luck, Joy

Steve! You're killing me although everything you say always seems to really cheer me up. We should have some duct tape around here thanks to Hurricane Charlie's pending arrival. Thanks you guys for all the support and encouragement. Found out the packet was sent and my insurance is GREAT, they processed it immediately and forwarded it to medical review right away. I should have an answer in 24-48 hours. Wish me luck. Also, all insurance companies are different. Some will approve pending further info. while others have set expectations and will not even look at your case until it's all there. Also, not all BCBS' are the same either. I have BCBS of FL State Employees...and to prove the difference I found out today that BCBC FL State Employees is the ONLY BCBS FL that will continue to provide WLS after Jan.1 contrary to prior rumors, atleast that is what they {BCBS} told me. Take care all and bunker down for that hurricane. Will see you soon, when the weather clears!

Danielle, Sounds like all the info is there to me! I pray you get a speedy approval! MICHELLE