Blue Cross Blue Shield of Illinois - APPROVAL!!!
I just wanted to come on and let everyone know that I received my approval today from Blue Cross Blue Shield of Illinois PPO... I want to post my situation, so that anyone pursuing this can see a positive outcome from BCBSIL.
I am doing to the Realize Gastric Banding Procedure. I have had a BMI around 40-48 over the last 5 years, have tried several diets over my lifetime. I don't really have any severe comorbities, except infertility issues and elevated blood pressure. I had about 12 months of documented Weigh****chers journals, but still had to do the 6 months of medically supervised diet/exercise. I started that process April 25, proceeded to go in May, June, July, Aug, and my final visit Sept 2nd. This was accepted as 6 months, although it was 6 visits, not 180 days. My Dr was great about making good notes in my chart, ie: vitals, weight, what I was doing, eating, exercising, what I should be doing, etc; and I went to the Dr specifically for this process. My information was submitted to BCBSIL in August to see if they would accept my Weigh****chers as part of my 6 months, and they replied that I needed one more month of notes, so that was completed Sept 2nd. That information was faxed on Friday, and I received my approval today, the following Wednesday. This process could not have gone smoother in my opinion. I think my very helpful Dr.'s office, Surgeon's office, and persistance were the key parts to this success.
I am having my surgery next Thursday, Sept 18th.
That is my story. Hopefully this can help someone going through the beginning stages of the whole process. Good luck to all of you.
Amy
I am doing to the Realize Gastric Banding Procedure. I have had a BMI around 40-48 over the last 5 years, have tried several diets over my lifetime. I don't really have any severe comorbities, except infertility issues and elevated blood pressure. I had about 12 months of documented Weigh****chers journals, but still had to do the 6 months of medically supervised diet/exercise. I started that process April 25, proceeded to go in May, June, July, Aug, and my final visit Sept 2nd. This was accepted as 6 months, although it was 6 visits, not 180 days. My Dr was great about making good notes in my chart, ie: vitals, weight, what I was doing, eating, exercising, what I should be doing, etc; and I went to the Dr specifically for this process. My information was submitted to BCBSIL in August to see if they would accept my Weigh****chers as part of my 6 months, and they replied that I needed one more month of notes, so that was completed Sept 2nd. That information was faxed on Friday, and I received my approval today, the following Wednesday. This process could not have gone smoother in my opinion. I think my very helpful Dr.'s office, Surgeon's office, and persistance were the key parts to this success.
I am having my surgery next Thursday, Sept 18th.
That is my story. Hopefully this can help someone going through the beginning stages of the whole process. Good luck to all of you.
Amy
Highest: 338/Surgery Day: 303/Current: 270/Goal: 180
CONGRATULATIONS on your new life AMY!!!!
BCBS of IL is very strict, but not unfair. They may seem to be giving the run-around to some, and maybe they did in the past, but if you meet the requirements and document well, it IS possible to be approved on the first try!
Good for you!
I am wishing you an uneventful surgery and a speedy recovery!
BCBS of IL is very strict, but not unfair. They may seem to be giving the run-around to some, and maybe they did in the past, but if you meet the requirements and document well, it IS possible to be approved on the first try!
Good for you!
I am wishing you an uneventful surgery and a speedy recovery!
Tell someone that you love them!
Dawn
253/223/167/127
HW/SW/CW/GW
I have BCBS of MN and I'm just starting out. I just had my first doctor supervised visit on 9-4. I am so nervous that something will go wrong because I want this so much. My surgeon assured me that as long as I jump through all over their hoops I will have no problem getting approved. I guess I just don't want to get my hopes up. I will be crushed if I'm denied.
Congratulations on your approval. You worked hard for your approval and you deserve this. Good luck with everything!!!
Congratulations on your approval. You worked hard for your approval and you deserve this. Good luck with everything!!!
Congratulations on your Approval!!! I have BCBSIL as well, and was finally approved for surgery October 16th for Lap band. It took me 2 denials and a "peer review" but they came through! I did weigh****cher's for 6 months however it was not "medically" supervised.
I was wondering do you know about how they cover the fills? I wonder if it's considered like a regular office visit with a specialist or what.
I heard some Insurance Companies only cover so many fills per life and that concerned me.
Thanks! Jeni
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