Blue Care Network

I know this has been asked or talked about before, but i'm super new. I just got off the phone with BCN and they said they are super strick with the 12 months of supervised diet. Now, this super sucks for me because i'm very impatiant. but i guess at this point i don't have a choice. I'm just wondeing if anyone else has delt with BCN and if so, what excatly did you need to submit to them......did it reallly have to be 12 months......could it be 11 months... and if as many people are having a problem with them and their rules as i am, who wants to get together and write them letters? I know other insurance compaines only require 3 or 6 months of supervised Diet. and i honestly think the cost of all the other medical problems i have will cost more to them then the last 6 months. I don't know. i'm just bummed about it all. Jenny

Hi Jenny, yes, BCN is VERY strict about the criteria as well as making sure you are going through a center of excellence for your surgery (I was fortunate that this rule was made AFTER they approved me so I could still go through Beaumont). I was told that your doctor needs to specifically spell out what he or she is seeing you for an example: I saw Ms. Jenny on 1/5/07 she has been eating a 1200 calorie diet and exercising by walking etc.... and has lost x amount of pounds, her blood pressure is and her current weight is.... just make sure your doctor says you are there to see him or her for weight issues, that is very important, this information would fulfill the required documentation. If you would like to find out what I had to go through, read my old profile, my husband is a Blue Cross Blue Shield employee and I was only approved after an in person appeal, trust me, the time will fly by I was very impatient as well, but in the long run it is well worth the wait, I am out 4 months now and down almost 90 pounds since September 11, I have to update my profile, but I am doing FANTASTIC and I feel great. If you need anything just let me know if I can help. Take care! Licia

Hi Jenny, I too have BCN. My Surgeons office sent in everything on about 11/29/06. By 12/8/06, I received a letter that BCN needs more information from my PCP. Pretty much nobody looked at anything during the holidays. I called them this past Friday and they said they just sent out a letter asking for more info. Believe it or not they can't tell me what they need. They said they can only give the info to my doctor! I guess the good news is that they haven't denied me yet. It is still pending. But I too am very worried about the 12 month thing. I go to the doctor all the time about issues related to my weight (like diabetes, high blood pressure, etc.) but they have never really put me on a diet except for when I was diagnosed with the diabetes. But from what I have read everyone says "Don't Give Up the Fight". Keep me updated and I will do the same for you. Best of Luck!! Joni

I too have BCN and I too was approved before they changed to Center of Excellence. I was actually approved 11 days before they switched over. I know that they are strict on the dieting information. You also have to have a psych eval by someone In Network. They told me I could go to someone out of our network as long as I paid for it and then denied me because I had an out of network psych eval. Just make sure you get names, phone numbers and extension numbers of everyone you talk to. Best of Luck. Stacey B

Thanks for all the advice. I hate dealing with the ins. compaines! They scare me :) I'm going to BCN's "weigh to go" program. So i'm hoping they will be able to give their own company the right amount of information. but if you guys have any pointers i could sure use them. feel free to email me [email protected]. thanks!!! Jenny

Jenny, I had an absolutely horrible experience with BCN, they were unprofessional and very incompetent. Really, i think that they just deny everyone and hope that you wont fight. So frustrating!!! It took me 15 months to get approved, and yes they are very strict about it. Do you have the guidelines from them? After I was denied the first time they actually send guidelines of what exactly they mean by "Dr. supervised weight loss program" and the requirements. I can fax it to you if you have a fax! Let's talk! Rebecca