BCN approval, does anyone have any tips?

I have been denied three times. The last time the ins company said that I only had 10 months from a structured diet program ,they said that they want 12 months with this program . I thought that they would consider the diet attempts with my regular physician. I have co-morbities and and am a perfect candidate for the surgery I think that they are wanting me to give up. I dont want to have to start another 12 months of a structured diet program, does anyone have any advice, or has anyone got approval through BCN ?

Hi Tammy: I have BCN and if you have documented 12 months of weight loss attempts from your doctor that should be sufficient. Read your policy and see what they require. If it is lack of diet attempts, go see your PCP and make sure he or she documented your weight, blood pressure and so forth and that you talked to him/her about loosing weight. You said you had 10 months of documented weight loss in October, you should have had 12 by now if you continued to see a doctor for weight loss, I would ask Cori to re-submit with the updated medical records showing your attempts. I am in the appeal process now I have not been denied for lack of 12 month just lack of medical records so I am covering my bases with an appeal letter regarding the 12 month diet. Hope you get approved soon and DO NOT GIVE UP NO MATTER WHAT that is what they want you to do. Licia

Hi Licia thanks for your info, but cori told me that im on my own , so now I have to file a grevence with bcn and I have to do the rest of the work myself now. bcn told me that it has to be with a structured program for 12 consecutive months , I am going to write a tear jerker letter to them { I hate to beg} but I guess I will have to , they said if I get denied again then I can do a sit down meeting with them . yea Im going to show them I dont want to give up I hope it does go through because I dont think that I can do 1 more year of a structured program. Thank you for your info.

Hi again Licia good luck on your approval and let me know what happens. Tammy.

Make sure you not only address the reason they denied you in your letter, but also be sure to touch on all of your comorbidities and how being obese affects your activities of daily living. At this point, they do just want you to give up, but you're not going to do that!

Hi colleen thanks for your support, no I dont want to give in im already working on my letter its already 4 pages long.