OMG I won round 1 with Ins Co!!!!
This is long story and I'll try to keep it short. I'm a nurse at a hospital with a union. Our union contract states we must have BCBS or equivilant. Hospital changed ins co Jan 1st. New ins co bariatric surgery guidelines are WAY more stringent than BCBS. I brought this to the attention of HR who agreed with me and asked ins co to follow former BCBS guidelines. Initially ins co told me they never received such a request so yesterday was the deadline for me to file a grievance under my union contract. When I told the CSR from the ins co I would be filing a grievance and starting the arbitration process she was suddenly very willing to let me talk to the supervisor who was just not available then and said she would call me back. Well she called back today and said, yes we will be using the BCBS guidelines as requested by your employer! Wow, those two litle words (grievance, arbitration) must be powerful!!!! They did a complete turn around in less than 24 hrs. I *believe* that I qualify under the BCBS guidelines (a little worried about the phys supervised diet part, but I'm 1/2 way through another 6 month supervised diet just in case). At the most I'll qualify by June!!! Yeah! Doing the happy dance here.....
~Shawn~
Revision to VSG from Lap Band due to slipped band
Go confidently in the direction of your dreams. Live the life you have imagined.
~ Henry David Thoreau ~