I'VE BEEN APPROVED POST IT HERE

Great West insurance rocks!  In less than 2 mos I completed the process and received my approval from them.  My paperwork was submitted Friday and it only took 3 days to make a decision!

I was approved on 3/28 for lap band.  It took United Healthcare just under three weeks to make a decision. 

Called BCBS Illinois PPO and after waiting while they researched, they said I was approved.  Originally submitted 03/22/07 from surgeon's office.  Had to resend most recent medical records on 03/26/07 and routed to Medical Review Unit on 03/27/07.  Resent up to MRU on 04/03/07 (BCBS cust service rep was pretty ticked at their internal processes! ).  Resent again on 04/11/07 (and again, cust serv rep was peeved at how their internal process wasn't working).  Got approved yesterday and they told me today!  Yup, going to Weigh****chers and having a monthly appt with my PCP does work!  (At least for me ymmv).   Thanks to all who have supported each other.  Sometimes, a reply you made to someone else has helped me hold on.  Thank you! God bless! 

My insurance company received my claim on 4-13-07...and today, one week later, I received a letter in the mail...APPROVED!!  My insurance company is Freedom Network~Construction Worker's Industry Laborers Fund, and they didnt require any form of weight loss history or supervised diets, just a BMI of over 40. I did talk with the lady at the insurance company, and she said the only reason they give for denials is a BMI to low, or one over 50, or not having all the required paperwork in (letter of medical necessity from the PCP and surgeon, a NUT consult and a clearance from the psych) All in all, working with the insurance company has been fairly painless, but that was with the help of the surgeon's office who filed the claim on my behalf!!  The next step for me is to get a pre-op surgeon's appointment, and get my surgery date!! I wish every one as much succes as I have had!!

Hello My name is Barbara I also have BCBS of Illinois. I have just been told I was denied and they needed more  information. Did you have to complete 12 consecutive months with Dr. I have completed this as well as phychitric eval upper gi echo stress test  sleep apnea study. I dont know what else they want. If you have any suggestions Iwould greatly appreciate them, I am getting frustrated. I also wondered where you had surgery. Was it a center of excellence I thought maybe that would help if I switched to one since  have already met requirements. Congrats to getting approval I would appreciate any of your valuable insite.  Thanks Barbara

Hi Barbara!   Yes, I had a center of excellence.  I had to complete 6 months, not 12.  My first suggestion, contact the phone number on the back of your card, which is the customer service folks at BCBS IL.   (They are only open weekdays, central standard time).  Once you get to a real person (you have to put in your group number and stuff) get that person's name and ask for their help.   Just put yourself in their hands and let them help you.  Also, ask for their extension so that you can call them for help from this time out.  Just let them guide you.  I had a gal named Deborah, and she was wonderful.  She became my advocate at BCBS and she made sure stuff got to the proper places.  The company sometimes can misplace stuff, so they may actually have all the documentation needed, but the person who needs it hasn't gotten it yet.  I'm rambling, but what I'm trying to say is let them help you.  If you need more, let me know.  Good luck! Robin

Hello Robin Thanks girl for the information. I am at my wits end most people only have 6 mos I dont know why I had to do 12. I know several people with different  insurance that started after me that have alreadt had their surgery. I wonder if you get approved quicker at a center of excelence I think Ishould check that tomorrow. I will call bcbs first thing in the morning and follow your advice . Thanks again  I will keep you posted on outcome. I also forgot to tell you I want to have Lap Band . Some say it is harder to get approved than gastric . Hope  this is not the case. hope to see ya on the losing side. Thanks Barbara

Hello Robin  This is Barbara I just wanted to say thanks for your help it really paid off. I was just about ready to give up and you gave me great advice on dealing with  bcbs. I just wanted to let you know I got a call from my surgeons office 07/23/07 that I am approved and have a consult on sept 12 to set up surgery date. It was a long haul of 14 months to approval but it is people like you that helped me get to the finish line.  Thanks again Barbara

Barbara that's wonderful!  I am so glad for you.  Keep us updated on how things go and make sure you let us know when your surgery date is!

Carefirst BC/BS National Program approval finally in this past monday.  I started the process in January.  They didn't deny me, but around the 2nd week in February requested any 6 month diet info.  I managed to wrangle it out of WW, and faxed it in on 3/27.  I was approved.  That phone call made my day, week, month, and year!