approved for VSG

Well it took 10 days but i just got a call from my surgeons office that empire BCBS approved my sleeve. i called last week to talk to a case mgr. but was approved before she even called me.
I'm quite sure my PCP's letter about my vitamin deficiency helped put this thru so quick.

Was the sleeve considered investigational for you? I have Wellmark BCBS and it is for me unfortunately. Congrats to you!!!

i don't know what they considered it before now. the insurance lady that works for my surgeon didn't want me to even try for the sleeve, because it had never been approved by my insurance before. So i'm guessing they have just updated there policy reguarding WLS.

best of luck to you.
 

that is so great,,, yeah   yeah  yeah,   i'm waiting to hear about my appeal d/t investigational,  please God they will all update there approval because it has been proven to be affective, congratulations,,  that's so cool,, hoping to be right behind you,,,, on the path

well i got a call yesterday from the ins co.. now they are saying I've been denied because they consider it investigational, with i argued that i already had an approval, but the lady said she didn't know who called my Dr. but they were wrong.

So how are you appealing? do you mind sharing your strategy?

Sorry about that, I kinda figured there was a mistake somewhere. :o(

OMG  that SUCKs big time,  there are a couple of places on this site where people who were appealing will send you or you can look up a copy of the appeal letters,  if you put in the search line, help with my appeal letter, several links will come up,  i had a gal send me a copy of her letter and i looked at the letters on line,  and i just edited the letter with my own information.  I have HMO so the HMO decide if you are approved or not,  however, because they still list it as experimental, the sent me a letter saying "this is not a denial of service, but the service that you have requested is considered experimental/investigationa" so i called my HMO and they said i had to send an appeal letter to the company.  So that's what i did  my surgeon's office wouldn't help,  they said they don't appeal the sleeve,  they just want me to say oh ok  then lets ask for the bypass,  but i REALLY DON"T WANT THE BYPASS,   for so many reasons,   so i'm not really hopeful that it will work because no one on here knows anyone who won on appeal,  but i have also been told that if the insurance company denies your appeal you can go to the State insurance commissioner and that they can overturn the insurance company,  since Kaiser and United now offer the sleeve, it obviously is still not considered investigational because Kaiser doesn't do investigational procedures'  so my only hope is that they will overturn Blue Cross,  I'm sure my corporation pays as much premiums for our coverage which does include WLS as the other corporations pay for their coverage so it doesn't seem fair that one company will offer it and another will not,   not sure what i will do if this doesn't work, so they have to decide by thursday on my appeal,  and if that doesn't work i will take it to the next level,   best of luck to you and me,