Your experiences with...

BCBSIL Anyone willing to share their experiences with BCBS of IL (PPO). I know everyone's experience is different , but I would still like to gain some insight on what they are like to deal with. Thanks a bunch! -Sam

Thank you Paul...

I did have that trouble with my last insurer (administrator of policy) and was subject to exclusions. However, this insurance policy is all BCBS of IL I called today to verify that and checked their website to see what the "rules" are.

I am wondering what they are like to deal with - just to make sure I don't make any common mistakes or if someone in their member services department is easier to deal with than others... So if anyone has any insight into working with them and doesn't mind sharing, I am all ears!

Thank you!!
S

I have sent off a few pre-determinations to BCBS IL for my docs. The key points I have noticed are: make sure the diet is a full 6 months, with good monthly documentation, do not short it by 20 days...meaning if you begin at the end of a month, finish your 6 th month at the end of a month...you know what I mean? also, make sure the info is clear, don't send 5 years worth of records they have to dig through, only one weight per year is necessary. I have had good luck with them, they will call me if more info is needed, some insurers just deny and do not give an opportunity to send more info, unless it's through an appeal. They also give me an answer in 2 weeks, usually. Good luck! Bonnie

Thank you Bonnie!

I am a RN and work for an insurance company doing approvals for WLS.  I made sure I had everything prior to submitting for the authorization for surgery.  Well, I was denied, and no one on the phone could tell me why.  I received the denial letter, and it just stated the policy.  My surgeons office has turned my case over to Obesity Law.   I hope your experience is better than mine has been. Gina

I hope it goes well too... I'm starting over again in the process. First time around I found out my insurance had "exclusions" because the policy was through my employer and not through BCBS of MN. All I can say, Gina, is hang in there.

I have them.  I got approved back in March.  Couple of pointers.  From what I have heard, make sure your pre op diet is Dr supervised.  Mine wasn't, but by the grace of God I got through. I have heard of people who have had problems by just doing WW.  That may be why they asked me for a letter from Nutrionist.  Whcih, I also got very quickly because I was seeing on for a new diagnosis of diabetis.  After that was submitted they did deny me.  It was more they wanted additional information.  I was diagnosed with a heart conditionfew years ago that resolved itself and I have asthma.  They wanted me to get medical clearences for both.  Once i got those is I was approved.  They are very through.

Thank you for the info! I have almost 3 years worth of notes for a supervised diet; however, it was between 2002-2005 and I do not think they will accept it.