BCBSIL - Are you Suprised?
I apologize in advance as this will likely be a long-ish post.
In Jan 2006, I started Weigh****chers, and went til April 2007. Along the way I joined a gym, and have documentation of all my attendance records for each. At that time I did not have any intention of having WLS, I was doing it to try again to lose weight and get healthy, etc.
In Nov 07 I started researching WLS, and went through all my appts with psych, nut, etc. On Dec 13, I was submitted for approval.
After six weeks of faxing, re-faxing docs, they now have over 100 pages on me. I meet the requirement for the BMI, the five year history, but I am stuck with the supervised weight loss.
Because I did Weigh****chers on my own, with no intention of having surgery, I did not do it under my PCP's supervision. He did however, recently write me a letter recommending me for WLS.
So even though I did well over the six months required, and show docs that I actively participated in a recognized weight loss program, I am denied because my PCP did not supervise me or document my process.
My question is this - Is it even worth fighting for? I have an appeals letter ready to go, but since we only get one shot I don't want to blow it. Should I just suck it up and go through the supervised six months?
I am at a loss and obviously discouraged. Just wanted some opinions from those of you who have dealt with them before.
Thanks so much in advance
I just got approved thru BCBSIL this week and Ill just say if you dont have documented with you PCP that you were doing weigh****chers and working out they wont approve you. That was one of the things my surgeon emphasized. I had been doing weigh****chers for sometime myslef and seeing my PCP every 3 months and that wasnt even good enough. So my suggestion is go ahead and suck it up and do the 6 months diet plan. But on the brighter side after i did it my paper work was recieved on Monday and I got my approval on Thursday. Dotn get discouraged and dont give up.