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Topic: RE: BCN MI waiting
No, It took 19 days for bcn to approve but I have my date of may 8th... I called everyday.. Don;t think it changees anything....Have faith I know I drove myself crazy with worry.
Topic: RE: BCN MI waiting
Are you still waiting? My paperwork was sent to Blue Care Network on 4/19/12 and I am wondering how quickly it will come back?
Topic: RE: BCBSNJ....PLEASE PLEASE HELP ME...TIME IS SHORT !!!
How are you since surgery? Are you able to be up and about in a few days? I am wondering about people who went from lapband to vsg a year later. Do you know if they have to do the diet?
Topic: Need some assistance with my appeal...please!!
Hi all. I am getting my appeal ready. But I am hoping to gather some info first. If you don't mind sharing, I am needing, specifically, what insurance you have and how long was your medically supervised weight loss requirement. For example: Amerigroup (Nevada Medicaid), 3 yrs.
I am finding that most insurance copies require 6 months. Mine is 3 years. Yikes. So I wanted to include that data along with all the other info I have. Thank you so much...I greatly appreciate it.
I am finding that most insurance copies require 6 months. Mine is 3 years. Yikes. So I wanted to include that data along with all the other info I have. Thank you so much...I greatly appreciate it.
Topic: RE: UHC 6 month diet/My Experience
ETA: I GOT APPROVED!!! Just found out tonight ;)
SO just more evidence that you don't need to do the 6 month (IMO waste of time) supervised diet.
SO just more evidence that you don't need to do the 6 month (IMO waste of time) supervised diet.
Topic: Approved! UHC community plan
I just called to find out the status and found out I am approved!!
My initial submission was denied after 2 days. I appealed and 30 days later they overturned it and APPROVED me!!!
I didn't do the 6 month diet. I just had my PCP list a few of the diets I had tried and state that none of them will work and that WLS is the only other option.
I also didn't have documentation of being obese for 5 years. I explained in my appeal letter that I didn't have insurance then and therefor could not afford to see a doctor in the past few years. Instead, I made a photo album with pics of me from each of the past 5 years. I signed and dated the back of each one stating my estimated weight at that time.
If you have any other questions, ask away!
My initial submission was denied after 2 days. I appealed and 30 days later they overturned it and APPROVED me!!!
I didn't do the 6 month diet. I just had my PCP list a few of the diets I had tried and state that none of them will work and that WLS is the only other option.
I also didn't have documentation of being obese for 5 years. I explained in my appeal letter that I didn't have insurance then and therefor could not afford to see a doctor in the past few years. Instead, I made a photo album with pics of me from each of the past 5 years. I signed and dated the back of each one stating my estimated weight at that time.
If you have any other questions, ask away!
Topic: RE: UHC 6 month diet/My Experience
I agree. I have UHC, too, and I am submitting w/o the 6 month thing. I was denied initailly, but am currently on appeal. I will have my decision in 2 days (4/18).
I had a breast reduction last year that I had covered by my insurance. My doctor's office said I wouldn't get approved because UHC requires 3 months of physical therapy. Well I said I would like to go ahead and submit w/o it. I was approved after 2 days.
So, I agree w pp, you have to be your own advocate. You have do all your own research and be agressive sometimes.
I had a breast reduction last year that I had covered by my insurance. My doctor's office said I wouldn't get approved because UHC requires 3 months of physical therapy. Well I said I would like to go ahead and submit w/o it. I was approved after 2 days.
So, I agree w pp, you have to be your own advocate. You have do all your own research and be agressive sometimes.
bearomar04
on 4/16/12 1:06 pm
on 4/16/12 1:06 pm
Topic: RE: BCBS Healthselect State of Texas employees
Hello World!!! I have a date yes after trying for over 10 years I am now scheduled to surgery on June 11, 2012. Pray for me. I must say I am a little scared but I have waited long enough. I hope my tests before the surgery are ok. Again pray for me.
Topic: Phoenix Health plan, AHCCCS
Hello all,
I have ahcccs (Phoenix Health Plan) and I was wondering if anybody has been approved through them, what type of surgery, and how long it took...any info is greatly appreciated!!! I am hoping to have the VSG. When I call them directly, nobody can tell me what the requirements are. My surgeon says that they use the Mercy Care requirements because they couldn't get an answer from PHP either. I asked them if the VSG was approved and the guy said no, that it required a prior authorization but I am pretty sure they all do. Just wondering if anybody else has had experience with this. Thanks so much!
I have ahcccs (Phoenix Health Plan) and I was wondering if anybody has been approved through them, what type of surgery, and how long it took...any info is greatly appreciated!!! I am hoping to have the VSG. When I call them directly, nobody can tell me what the requirements are. My surgeon says that they use the Mercy Care requirements because they couldn't get an answer from PHP either. I asked them if the VSG was approved and the guy said no, that it required a prior authorization but I am pretty sure they all do. Just wondering if anybody else has had experience with this. Thanks so much!
Topic: BCN MI waiting
After 7 months of pcp visits, testing evaluations and appointments. my paperwork was submitted 7 days ago. God the waiting is like a slow torture.. Don't know what I'll do if it's denied.. I have suffered for 45 years of being overweight. I think I deserve a break now........G. S Worried in Michigan.
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