BCBS IL approved on appeal with Obesity Law

Thanks to Kelley and Walter Lindstrom @ Obesity Law, I was approved with the first appeal.  I am so glad they handled my appeal from the very begining as it is such a crap shoot to get approved with BCBS IL. 

I don't understand how it is possible for insurance companies not to have to follow their own policy. 

Why were you originally denied? What did Obesity Law do for you to get this resolved? How much did their services cost?

I met all criteria for WLS per BCBS's policy.  I was still denied.  Obesity Law handled the appeal and got my case approved.  My surgeon paid the fee.  A lot of people with BSBS of IL get denied even though everything is received and all criteria is met.

That's great news Gina.

I have BCBS of IL and I just started my supervised diet. It is good to have a heads up regarding what I may be dealing with from the insurance company.

I got my first denial from BCBS of IL this week saying that I did not have the medically supervised diet even though my surgeon had this documented and my Weigh****ch membership cards.  She said that this was not enough to show that I went to the meetings and they told the doctor that I needed to lose more than I did on the diet.  Can they stipulate how much weight you lose during the medically supervised diet?  My doctor resubmitted with an appeal letter but he did say that they always deny the first time and BCBSIL is the hardest one.  I am trying to remain hopeful and patient.  On the positive side they reviewed the first one within a week so I will wait until next week and call.  A

It just depends on *****views your case.  Some get approved with no problem, but there are quite a few of us that get denied for no apparent reason.  My denial letter didn't even say why I was denied.  They just said denied and listed the policy.