Anyone every win with BC/BS of AZ after second appeal?

Just starting the second appeal. Denied because I am missing the month of May in my 6-month consecutive diet records. I have January through April and June through September. Can you believe it....

Sorry to hear this Linda. Isnt there anything your doctor can submit to show that you have been consecutively under his care? Cant he write some sort of letter on your behalf? I have BC BS and I didnt have any trouble with the approval process (although I thought it was a bit ridiculous that we had to show 5 years worth of medical records supporting the obesity diagnosis!!!) Keep the faith an dont get discouraged - may you hear some GREAT news soon! Take care.

Hi Linda, I have Blue/Cross/Blue shield of empire (New York). From what I understand, they go through the basis same criteria as the AZ BCBS. I was heart broken when after I completed all the criteria on my list..I was told my my surgeon's office, that I needed a 6 month dr. supervised diet. I was sent a piece of paper for each of the six months, and I had to have the doc sign it and personally witness the weigh-in. It was simply put, the biggest waste of time I ever went through. They told me that I would have to start over if I missed a month also. Fortunately, because of my health problems to begin with..I had dr. visits to prove I was weighed and visited. I just had to have the doc fill out each form and sign. I also had to go 3 more months for the weigh in..can you say humiliating???I felt like a grade school kid with a note from my parents. I wanted to fight BCBS at that time because I was never given that requirement from the beginning..only AFTER I submitted the paperwork the first time. I was told by Fang's office that I techniquely was NOT denied. I just had to give it the 3 month diet. I lost the same 5 pounds throughout the whole 6 month ordeal. There is really no reason to put us through this criteria except to get us to give-up and quit....after all, they don't want to pay for this surgery. I did finally get approved and had the wls. I did have some complications. It was overwhelming to recieve the "this is NOT a bill--bill" that stated my surgery to $. 76,500 and some change. Don't give-up!! that is what they want you to do. Go back and do the 6-month diet thing..if that is what it takes. I know that it is hard.. but they were very firm on this one. I get so jealous of people who simply submit and are quickly approved aren't you? Good luck! Hugs, Ginger

I won on my second appeal. The first time they also said my diet records were incomplete. So, I went another six months of visiting my Dr. every month for a weigh-in. I also had him write down that he was perscribing 1200 cals/day and 30 min of exercise. I did this for six-months, I also subscribed to Weigh****chers, just in case. After six months, I resubmitted and got an approval within a month. It can be done!!! Good Luck!!!

Hi Linda: I have BCBS of AZ. I was told to put my ins submisson on hold for 4 months due to missing one month. Finally, I got the 6 months of diet records, and they wanted to deny me still due to not having records of my eating... FORTUNATELY... I had been keeping a health/diet record for TWO YEARS...in it were daily logs of food, and more importantly--how I FELT consistently for those two years. I had many days when I felt like I surely would die...pain, depression, diabetes problems. I was fortunate enough to be approved due to this...in fact the nurse at BCBS (I was told by my surgeon's office) was actually "delighted" to call w/the approval. Go figure. Be patient... 6 months is a relatively short period when you consider the outcome! Liz G