Carefirst Blue Cross Blue Sheild

I have Carefist Blue Cross Blue Sheild.  I am not sure if it is MD or KY since the paperwork I get itemizing MD appts says MD and when I asked them to fax the criteria the fax came from KY.  Here are my questions: Does anyone have this company?  What state do you live in (I am in MA). How long did it take for you to get a decision? Were you approved the first time? The criteria says 2 three month supervised diets or one 6 month supervised diet.  Weigh****chers/Jenny Craig is acceptable.  Can I show journals????  I no longer have the pay stubs. Thanks for your help!

I don't have Carefirst, but I do have BCBS IL. I had a year of WW records but was told it was not acceptable. Generally the insurance company like to see you're on a very low calorie diet. You can participate in WWatchers and/or Jenny Craig; however, you must also visit your PCP every month for 6 months. DO NOT SKIP A MONTH! Otherwise you will have to start the process all over again. The PCP must weigh you and document all discussions regarding your weight loss. I hope this helps you out some. Take care 

Hi -  I have CareFirst BCBS - Its based out of maryland but I think they have a call center in KY but don't quote me on that.  I live in PA and looking to get my surgery in MD. YES  - WW and JC are acceptable - you will need to show your weigh-ins (that's the supervised part).  YOu can include your journals but its not enough.   My doc sumbmited my paper work and it took 2 weeks to get my denial due to the medically supervised diets.  I could only get my JC pape work but a lot of my time was betweeen 2004 and 2006 so they did not like it.  I am about to submit my 3 months with JC from 2006 (which meets the critira of within the past 2 years) and I have about 3-4 month with WW and will continue to attend WW until I get my approval. G-luck!  Keep me posted and I will do the same for you!!! Iman

Thanks for getting back to me.  I  had a fax from them stating that for the "structured diet" I needed "One structured diet program for 6 consecutive months or Two structured diet programs for 3 consecutive months (can include commonly available diet programs such as WW or JC). Documentation that a patient has completed a structured diet program can be provided by any of the following: physician notes, notes of health care providers other than physicians, reciepts of payment for a structured diet program, or diet or weight loss logs from a structured diet program." I used my journals from WW and since I used the monthly pass I was able to get previous bank statements showing that I paid for a structured diet program.  I am assuming that worked because I got a date for surgery...7/15.  Hopefully this helps for you :-) Good luck! Kerri