I feel so discouraged

I called my surgeon's office today to get the number of the nutrisionist. i spoke with one of th coordinator's don't get me wrong she was nice but she made my confidence drop. Long story short she was asking why a iwas doing the 6mnth diet. I explained the requirement. She said "u don't have BCBS of GA?" I sais no of IL. she said let me pull you file. as if I don't know(duh). well anyway long story short when she came back she went on to tell me that another patirnt has the same insurance and keeps getting denied for not have 5 yrs history. She only has 2. Well i only have 3. maybe i'm being silly but it just brought my spirits down. I said "well will the doc do a peer reveiw if necesaary?"She said yes but he tends to get anr w/ the other doc when doing them. She said VERY angry. i told her i understand i mean it's another doc questioning you medical opinion. She said exactly but he'll do them. she said he will write me a leter too. i said has been successfull overturning w/ peer reveiw?she said"i'm not going to discourage u but u have the toughest insurance,bcbs of IL,bcbs of alabama i think she said and she also said i think cigna. i can't recall but she said mine. i went on to get the # i called for and told her i have come too for to stop now and she said okay. thanks for listening. i can't stop crying. I know i haven't submitted yet but i just want to be approved. i am so uncomfortable. i want to LIVE. thanks OH friends for listening to me ramble .

Are the records that you have during the last 5 years?  The records that I sent to BCBS of IL was weigh in during a dr visit in 2000 that showed my weight at 288 which would put my BMI at 41 during that time.  That is the only thing that I sent them, so it must have been enough because I got my approval yesterday.

Congrats!!!!! You'll be a loser soon. well from what i know they want 5 yrs history.1 record from easch year to show obesity for past 5 yrs. I have not got the record from 2003 yet. i don't kow what myweight was on that visit. i have no records at all from 2004 or 2005. I didn't go to any doctor at all. I had no insurance. I have 2006 and of course 2007.my bmi from the 2005 record was 44. my bmi now is 47.3 did u have co-morbids?

I have that insurance and I ended up getting approved. The peer to peer review pushed it through. As I said before I did not have the exact 5 yr history as I was in college and only had weights when i went to student health which was not often. Keep it up and keep on them

thanks for the encouragement. congrats. i'll think positive!

Don't know anything about that insurance, but keep your head up, and keep fighting, and vent away anytime. Dee

I have BCBS of IL.  The buggers denied me 4 times telling me they needed more info.  Then finally just denied for some BS reason.  I had to hire a lawyer to do my appeal because I only get one.  They will be sending the letter this month for the appeal.  I have a full five years of history of which I dropped below 40 bmi because I was on a diet supervised diet and when I was on my 6 month requiered diet.  But my BMI was still above 35 and I have co-morbidities.  They told me that my co-morbidities have to uncontrolled.  Uncontrolled my butt, my doc said if they were uncontrolled I would be dead.  If they deny my appeal then I have to go throught the IL Dept of Insurance and see if something would happen with that route.  I would suggest that you get a doctor's office that is a little more aware of what is going on with you as a patient as well as your insurance. But enough of the negativity I'm sure that something will happen for you.  I have been working on this since last October.  Take care!

I'm sorry to hear that. I hear only some good things about BCBS of Il. most are horror stories. why do u only get 1 appeal? i thought u can keep appealing. I hope all works out for u.