waiting for bcbs of ill approval

i was originally denied because of the way my doctor documented my weight loss visit. My doctor was nice enough to go back and document the visits over in the format that bcbs of ill wanted. i resubmitted all this info on Wednesday 05/10/07. Now the wait begins. Has anyone else had to ask their dr. to redocument? Did bcbs of ill accept the new notes? thanks so much

Its common.  As long as they don't think he faked anything you'll be fine.

HI...  I have BC/BS of IL and I am going to have my paperwork turned in at the end of the month... could you please tell me what format BC/BS wanted. Good Luck Susan

Hello, When I called BCBS to see what they wanted, I was told that my office visits did not have enough information documented. The rep sent me to bcbsil.com and had me look up the criteria required for approval. If you call customer service they can talk you through to the right section. I will show you how we did it. they wanted these 5 things documented for every visit: Nutritional Therapy Behavior modification or behavioral health interventions Counseling and instruction on exercise and increased physical activity Pharmacologic therapy (as appropriate) Ongoing support for lifestyle changes to make and maintain appropriate choices that will reduce health risk factors and improve overall health We took all my visits and put the information in this format and my physician signed each document. I hope this helps.  Good Luck!! Let me  know how it goes. Teresa

thanks I have my doc signing a form that has...  Date: Weight: Weighted at: (location) Excercise: (moderate walking) Diet Pills:  (none) Current Medication: (multi vitamin) Behavior Modifications Discussed: (continue to use written food journal and portion control and excercise.) Additional Comments: Signature:  I have a copy of my doctors actual notes that she has in her file too, that I will send if need be.  Do you think this is enough information to show the diet. Did you send in 7 sheets or just 6 weighins?? Thanks Susan

Hi When I started, the insurance required a yr of visits. I submitted a whole years worth of visits.  I think the more info you have, the better your chances are. I had date, weight, bmi, blood pressure, and weight gain or loss on each visit. My documentation also showed what kind of diet i was on, what problems i had with following the diet for the previous month. It shows how much and how often i walked each month. It showed that I had trouble with exercise due to my weight. I would not take any medication for weight loss because of the phen-fen drug, so we documented that every month. We talked about family support and help with weight loss and weight loss surgery. The more info you have I think is the best. I am still waiting to here from insurance to see if they approved me. I will let you know if my documention worked.   Good Luck teresa

Hi Tesa, I also have BCBS of Illinois. My surgeon's office submitted my records about 2 1/2 weeks ago. I have not been "denied," but they couldn't approve it without additional documentation. I was wondering what format they wanted your documents sent in. They didn't ask for redocumentation, but, when I asked what specifically they needed from me, they pretty much told me that they needed everything that they require, as if what my surgeon's office sent in was not what they asked for! If you have any advice for how to resubmit my records, would you please let me know? Thank you so much! Karen