BCBS of MI help!

I went to my first appointment at MMPC in Grand Rapids about a month ago. The person who I had my first apt with has the authority to approve my surgery. She said she couldn't because I didn't show a full 12 months of supervised weight loss attemps. I now have a letter from my doctor showing that I have been on several supervised diets under his care. Does anyone have advise for me?

Hiya! I have BCBS and they required 12 months of weight, diet attempts (weigh****ches etc.). HOWEVER when I called BCBS they helpful lady on the phone suggested that I get my BP taken as well as any complications (sleep apnea, joint pain etc.) documented monthly as well. My recommendation is call BCBS and ask how they want the material presented- I did and was approved the first time with no hassle. Hoops there may be but I jumped and it worked out well! Best of luck! Jennifer

I have BCBS Comm Blue PPO of MI. I was also required to have medical supervised weight loss for 12 months. I was able to provide 10 years of medical weight loss supervision plus a letter from my doctor. Write down what types of diets you went on, who with, how you did, lose or gain, and such. Document all of it. Go back as far as you can. The more detail you provide the better. And also, make sure that there is sufficient documentation of any co-morbidities you have/had, such as diabetes, high blood pressure, sleep apnea, chronic illnesses, high cholesterol, etc. I had severe back pains also which helped. And medical documentation that all the weight was a strain on my already weak back. Write basically a few pages of all the information above, and that could be sufficient for BCBS. Again, agreeing with previous post, contact them yourself to find out "EXACTLY" what they do require you have. I know my process was the psych consult first, after the referral to the WLS surgeon from my PCP. That was mandatory. Good Luck! Stacey W

I would call the office and speak to there insurance biller and see if she will submit the letter with your paperwork actually at mmpc the person who makes the final decision if you are a canadate for surgery is the surgeon and it looks like you have Dr Kemmeter and I think he will help you get the approval, I had BC when I had surgery and I did not have the 12 months of supervised diet and I was approved and had my surgery with Dr Foote. Just keep on top of the process and you will have it done in know time. Hugs Tricia

Do you have any medical problems or potential problems. Make sure your PCP writes a very detailed letter.