I got approved today!!!!

Hi Everyone, I got approved today.  The records were faxed to Blue Cross on Tuesday and they were reviewed yesterday.  It actually took one day because I was approved the same day as my file was reviewed.  I wrote Blue Cross a seven page letter cross referencing the medical criteria stated in Blue Crosses medical policy manual against my medical records.  I provided BCBS with all of my past med recs even pharmacy records, multiple letters from various doctors and a complete history of my BMI through the years.   When I found out, I cried.  I thanked God.  This is all I have every really wanted, to be thin and healthy.  I can't believe this is actually happening.  My surgery date is pencilled in for Nov 5th, 2007. Janet   

Congrats !!!! It will be here before you know it.

Great News Janet!  Thanks for sharing your exciting news.  Christina

And I thought mine was approved fast (7 days). Good luck on the rest of the journey, and we both will be on our way before Xmas! Lisa

Congrats on your approval and upcoming surgery!!!

WOW! Congrats! I was denied bc BCBS of IL. I have done everything they said but for some reason I am being denied still. I am trying not to give up like I have in the past, but I am tired of being let down. May I ask, what exactly did you say in the letter that cross ref. the medical criteria stated in BC's med policy manual? Juts trying to get advice so that I can continue to appeal their decision. Just not sure what else to send.

I listed my comorbid conditions.  You must have at least two of the following five: HTN, Hyperlipidemia, Sleep Apnea, Diabetes, Heart Disease.  I have 4 out of the five. I also listed every other medical problem that I have related to my obesity, such as gerd, asthma,  problems with my weight bearing joints. 

List all doctor appointments and nutritionists appointments for a six month period.  You must be weighed in each month, never missing both appointments.  If you miss one month, then you must start the process all over again.

Explain how much pain you are in both physically and emotionally.  Tell them the simple things that you can not do.   List your BMI over a 5 year period (as your medical records should contain your weight at each visit) You can figure out your BMI online. 

List all of the diets that you have been on.  State that you have even tried medifast and or optifast. Tell them that you have made changes in behavior modification.  That you have joined support groups such as OA or whatever (counseling) to realize the step you need to take to change your life. Let them know that you have been unsuccessful at these attemps. Provide a food log and excercise log over the past few months that shows your attempts at weight loss.

Include the medications that you have tried in the past for weight loss.

Your BMI must at least be 40.  Hope all of this helps.  If you still need more info, send me your email address and I will share my letter with you.

Janet

 

 

 

 

 

Thanks! I appreciate the help.

EXCCCCCELENT NEWS!!!!!!! I am doing the Happy Dance with you!  I remember so well how it felt! Good luck with everything and you will be losing before you know it!

congrats on getting approved so soon, I hope mine comes back next week, as the dr. sent mine in on monday.  do you have a date yet?