Anyone with BCBSIL that got approved fast?

Hello my Name is Julie and I live in Indiana. I have BCBSIL and I was wondering if anyone else has it or had it and got approved pretty fast or how long did it take? Any help would be great. Thank you,  Julie Boyd of Indiana

Julie, welcome to the IL board. It all depends on whether you have met all the criteria for them. Have you gone through the 6 month doctor supervised diet? If you have gone through that and anything else that they are asking for then you should be approved fairly fast. I have BCBS of IL PPO and was approved in 2 weeks but I had my surgery 4+ years ago so you cannot use that as a barometer.  Christine

I have BCBS of IL that is PPO. After I jumped through all the hoops, 6 month supervised diet, psych eval, 5 yr history of weight. THey tried to say I did not have enough documentation but my surgeon did a peer to peer review and I was approved. It only took a few weeks

Julie, I have BCBS of IL and followed the process and was still denied.  I opted to self pay to get the surgery rather than fight  them. When I started the process it was 12 months of dr. visits.  It is now 6 months and it seems that they have let up a bit on denials as others have been approved. Keep good records and be sure to have everything in order before you submit.

 

Good Luck!!!

Mary

 

 

 

Dear Julie: When I started with BCBSIL PPO, I was first denied for lack of the 12 month supervised diet.  My doctors tried to argue with them, but they would not budge.  In month #9, I found that they had changed their criteria to 6 months, I sent in the records from the supervised diet, was approved within a week and had my surgery within 3 weeks.

The answer is that you must get a copy of the criteria, then make sure you meet ALL of them.  They WILL approve, but they are very strict about what they want and how they want it.

Feel free to read my long, long story if you wish.

Wishing you nothing but good luck!

Hi Julie - I do not have BCBSIL but wanted to congratulate you on taking the steps to a healthier you.  I was born and raised in Indpls.  Oh how I miss Indpls, and my family/friends.  My hubby and I moved to Chicagoland in April of 2004 so this is what I have to call home.  Some days are better then others. Where abouts in Indiana are you at? Take Care, Christina

Sorry to hear that! I also have BCBS HMO Il.From pcp to receiving the actual approval in the mail took just 2 days for me. Ihad to have all their requirements completed BEFORE I could see the surgeon for the first time. Those included: BMI over 40 ,12 months of dietitian visits, 6 month Dr. supervised diet[eg. W.W.], years of documention of obesity & comorbities. I've continplated WLS for years so I made sure every Dr I'd see would document something about my weight.I called BCBS before I received the first referral to verify that I was doing ALL to get approved. [this I learned from OH] Hang in there! Call they & ask what you need to do. They are there to help us! I wish you the best! 

Thank you all for your help. I'm almost done with the 6 months and i have all the comorbids and all the test's that they require. So with all that you guys are telling me looks like I'll get approved soon.  Again Thank you all, Julie From Indiana