BCBS IL-VENTING!!!

I am getting the same run around. My paperwork was submitted on 10/5/07. I called every 2 days. Well finally on 10/17/07 I was advised that 2 of the procedure codes were approved and one was denied. Well of course the RNY was denied. Well actually not “denied” the letter states it is not an approved benefit under my plan!!! Well I called again later that day and was advised that it is approved as long as it is medically necessary. She advised that I need to call my surgeon’s office and find out the exact code they are billing under. Well long story short. They had to resubmit with another procedure code. Now I have 2 FAF #’s(number used to track your file). 1 from the original 10/5/07  submission and one from the 10/22/07 submission. I was also told they don’t have my 6 month diet log that I sent in so…….. I faxed it today and was advised to call tomorrow to make sure they got it (it takes up to 24hrs.) Then once received I have to HOPE that they Customer Service Rep knows to send it to review board AND  reads the notes to know to reference BOTH my file numbers I am so aggravated about this. The good thing is that the reps have been really nice. What do youmthink about this? Any advise or encouragemnet apprciated.        

Go to the medical policy manual and search gastric bypass or morbid obesity on the www.bcbsil.com website.  It will tell you everything you need to have for BCBS to approve your request.  If you are missing info, they will not approve you until your file is complete.  Give them everything they ask for, and you will be approved soon.