BCBS

A friend is having problems with BCBS.  She just finished her 6 month doctor supervised visits.  Know the doctors office needs to have 5 years of documented WL supervised visits.  Does anyone know if you really need to do the 5 years or will the 6 months be ok. Here are other things that the doctors office claims that BCBS needs. Documented exercise program  Letters from doctors for the past 5 years. She also has a letter from BCBS telling the surgeon that she only needs 6 months supervised visits.  The letter is from November 2005. Do you think she need to get the 5 years of documents.   Any help will be appreciated.....

Michelle: Depending on which BCBS she has...but, if all that they require is a 6 month supervised diet (and she has that in writing) then her doctor shouldn't require anything more than that.  It's the insurance that makes the requirements, not the doctors.

Good luck with BCBS.  I have BCBS of IL, I have finished my 6 mo supervised diet and submitted to insurance and they denied me because they said I did not lose enought weight during my 6 months.  I had a reply from one girl that she lost under 5 lb and her insurance approved her, another that lost too much so the denied her because she could do it on her own.  I think it is just a game of russian roulette with these insurance companies.  I am in appeal right now and if that does not work I'm going to see a lawyer.

I have BCBS of IL and they required a 5 yr history of morbid obesity.  All I ended up faxing to them for that particular requirement was a page from a medical record from 2000 that showed a weight of 288 which would make my BMI 41 at the time.  It was enough because they approved it on 8/14.