BCBS Denied me!

kelle, bcbs sent it to me too , it took about a week to get it, then my dr. office mailed me a copy of all test and everything, when you get the letter it will tell you why it is not medically nessecery and you can go from there... I KNOW it is hard, i didnt expect it either, give yourself a few days and you willb e ready to fight!!!!! dont give up !!!!! see what they want and give it to them!!!!! email me if you want to , i know just how it feels....... [email protected] kiwani

KELLE I AM SORRY TO HEAR THAT YOU WAS DENIED BUT REMEMBER THIS :IF GOD BROUGHT YOU TO THIS HE WILL SEE YOU THROUGH THIS SO KEEP YOUR HEAD UP HIGH .god bless

Sorry to hear this Kelly, but don't stop now. Look at this as another stumbling block for you, just jump right over it and keep going. Let this experience make you stronger and give your DR office and insurance company HELL. Let them now you are not going to give up. Good luck and remember we are all here for you. Shondra

Kellie, It will take some work on your part, BUT you can file that appeal without their help. You really need to talke with Nat she can really help you. I have BCBS HMO, but trust me the MORE stuff you throw at them the more likely you are to get approval. I'm not sure what all you submitted. I'd be willing to help any way I can to get things together or let you know what worked for me. Basically everything that Nat listed, I also had. You may not need all of it but a stronger letter can help. I'm not sure if you submitted a letter from yourself, but I found out it really help. Email me anytime.

Kelle, Natalie F's post hit the nail on the head. I have BC/BS of Ga HMO and I was denied like 4 times. Because letters were not worded correctly. If your medical necessity letter does not state "MEDICALLY NECESSARY" they will reject it, also the medical clearance letter must have those exact words in it somewhere. But this is what I did, I called the pre-certification department myself, I didn't want my surgeon's office to do it because no one knows me better than me. I talked with one lady in the pre-cert dept, when she needed something I faxed it to her directly. I even talked to the nurse that is involved in making the approval decision. I didn't even have to file a formal appeal. When you call them, don't get an attitude, make sure she reads you the exact reason why you were denied, then ask them what you need to fax to them to get the approval. If your doctor is not sending the correct info in the letter, type one yourself and let them retype it on their letterhead. I've had to do that 3 times. But it's worth it. If you have any questions drop me a line, and I will help you as much as I can. Oh, make sure you call the pre-certification department because they can see all the info on your case and the customer service dept is only privy to certain info. I hope this helps.

Hi Kelle, I am SO sorry to hear this. I talked to you a long time ago...you probably don't remember me. I just wanted to say to KEEP TRYING. It isn't over yet and SOOO many people get denied at first. I sent you an email too. ~Susan

BC/BC HAS AN EXCLUSION IN THEIR POLICY FOR THE STATE OF GA. THEY WILL NOT EVEN SEND YOU A DENIAL LETTER BECAUSE THEY SAY IT IS NOT COVERED. MY BMI IS 47.5 AND WAS DENIED BY THEM. THIS IS THE MONTH FOR CHANGING INSURANCE. BC/BS HMO COVERS