bcbs of ga

Has anyone encountered BCBS wanting a 6 month diet history under doctor supervision before they approve.

Yes, I'm going throgh that right now with them. I don't know what the big deal is. I did weigh****chers, which really doesn't give you anything to prove this. The only thing I have is my journals with what I ate and the weekly weight. I don't know if this is sufficient because I can't get a straight answer from BCBS on what they actually need, but who knows. If they want that I will give that to them. By the time I finish copying all this journals it will probably be about 75 pages. Maybe I will overload them with it.

Hi Pam, I'm with BCBS of GA, too. I was approved after the first letter my surgeon sent. My surgeon is Dr. Champion in Atlanta. He had said that BCBS would require a PCP letter, Psych evaluation, and thyroid test. So, I had that done before they sent it in to BCBS. As far as the diet history is concerned, Dr. Champion wanted a listing of all diets that I had been on; medically supervised and not medically supervised. Now, that I think about it, I was on Phen-fen for approximately six months, so that might have counted as my "6 month diet history under doctor supervision." I honestly don't know. Good luck to you! Kristin in GA

Hi Pam, I just signed up for this message board last night and read your message this morning. I asked for a similar message to be posted, but it has not been posted yet. I am a retired educator under BCBS HMO under the state. I recently changed to this because they were the only choice that I had of a program that would even consider the surgery. I just received my first denial for the same reason. I am working on pulling together documentation at this time. If you attended Weigh****chers and have your membership book that you used when you signed in at the meetings, that might serve as documentation. I am going to write out a history to the best of my memory and list check stubs, credit card entries, and former insurance claim reports to help document. Also, I'm calling my diabeties doctor to see if he can give me a list of dates and my weight from my visites to him over the years. If this does not work, I'm not sure what I shall try next, but I shall be doing something else. Good luck. Let me know if you find anything else that might help us.

Hi, My name is Dana. I am going through Dr. Appels office. Just wondered if you are still pursuing with them and if so how are you doing. I got all my info for the "blue packet" and got my surgery approval (my hubby is military insurance wise) I see Dr. Appel on 3/19 and have been told my surgery should be about end of April if no new complications.

Hi, Dana This is Mary Lee again. I did persue my BCBS HMO approval and got it. I had my surgery (open) with Dr. Appel two weeks ago today. I am doing very well, so far. It is not easy, and you really need some help, especially the first week or two. Good luck with your appointment with Dr. Appel. He is an excellent surgeon. Mary