BCBS of MI and VSG approval....
Hello Everyone...
I have already asked a couple of people on here for some help, but wanted to post to see if I can get even more info from everyone...
I have BCBSM PPO Flexible Blue. BMI is 40/41, I'm currently going through the 6 month medically supervised weight loss, I have had all the testing done that needs to be done(and BCBSM paid for it) but I know I will be denied, my surgeon's office already told me VSG is not approved for anyone with a BMI under 50... well, I'm ready to fight, because this is the only surgery I want.
Any advice you can give me, letters you can send me, anything would be appreciated.... do you suggest I do anything special when they send in my info first time around or wait for the denial???
Thanks a ton ahead of time for all your help... Candy!
I have already asked a couple of people on here for some help, but wanted to post to see if I can get even more info from everyone...
I have BCBSM PPO Flexible Blue. BMI is 40/41, I'm currently going through the 6 month medically supervised weight loss, I have had all the testing done that needs to be done(and BCBSM paid for it) but I know I will be denied, my surgeon's office already told me VSG is not approved for anyone with a BMI under 50... well, I'm ready to fight, because this is the only surgery I want.
Any advice you can give me, letters you can send me, anything would be appreciated.... do you suggest I do anything special when they send in my info first time around or wait for the denial???
Thanks a ton ahead of time for all your help... Candy!
When I called BCBSM/PPO they said that it was investigational also unless it was done as a 2 part of the DS...which doesn't make sense right! But wait until the denial and the reason before you send over your supporting infor to get it approved. I am seeing more and more people getting approved for it though. Also on your appeal ask for a bariatric surgeon to be on the appeal committee. Best wishes!
Highest weight- 262lbs
Lap band- Aug 2006 - 254lbs.
Lowest w/band 214lbs. .
Gained up to 271 due to the band
Got DS revision April 2010!! Current 145lbs
At 5'8 my goal was 160lbs but I surpassed that with the DS!!!!!!
Lap band- Aug 2006 - 254lbs.
Lowest w/band 214lbs. .
Gained up to 271 due to the band
Got DS revision April 2010!! Current 145lbs
At 5'8 my goal was 160lbs but I surpassed that with the DS!!!!!!
Thank you so much to everyone that has responded so far... I truly appreciate it... I told the insurance coordinator at my surgeon's office yesterday, I will fight this to the end and she was all excited, she said we will do it together..... and that she loves a challenge, so that is encouraging to me too....
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