Blue Care Network has DENIED for the 2nd time...HELP ME PLEASE!!!

Ok...I am totally pissed ...the reason that they say is because I do not have the 12 consecutive months of supervised diet history...I have been going to my PCP for almost 3 years now and he wrote a letter along with myself and my surgeon.  My Pcp's  letter stated that he treated me for over 12 consecutive months evn though I was not weighed every month that I was still under his care .  So now I am ready to start the process of BCN Step Grievance Appeal.  This is where I may present the grievance in person or by telephone conference to the Step 2 grievance Panel...Any advice is surely appreciated. Thanks for listening, Renee

Hi Renee: I can only imagine how frustrated you must be, especially since you have a requirement for 12 months of doctor supervised weight loss.  During my orientation, my doctor's team  over emphasized the importance of following the requirement for doctor supervised weight loss to the letter.  That meant having documentation of monthly doctor's visits for nothing but the weight loss.       If you go in for a weight check and ask the doctor to treat you for a cold while you are there, that visit will not count and you will have to start all over!   They also advised us to schedule our appointments early in the month.  That way, if something cames up, you still have 2-3 weeks to get in to see the doctor.  If you schedule your appointment at the end of the month and missthe visit, there may not be enough time to see the doctor within that month and you'd have to start over.       By all means, appeal the decision.  However, if you are stilled denied, trust that things work out as they should and then go through the process. Many blessings, Dee

Hi Renee, I too live in Detroit and have BCN as my insurance. Is this the only problem that they have given you thus far? I was wondering about their processes. I have my first consult with the doctor on April 4th and I just really want to be prepared for what BCN is going to put me through. Anything that you can offer me as far as advice would be great! Thanks so much!