Approved after Independent Medical Review

 Blue Shield of Ca denied VSG stating it was investigational. That decision was overturned after an Independent Medical Review (IMR) and the decision came in about 40 days after my request. BS of CA would have authorized RnY, but that was not the best choice for me and my health condition.

Please don't give up without a fight and don't settle for a surgery that you and your doctors do not think is best without a fight!

Good luck to everyone.

I was denied by BCBS North Dakota the first time. I sent in my appeal a few weeks ago, and they sent it to an external review board themselves. I hope I am as lucky as you and get it approved. It pays to stand up for what you believe in, that's for sure.

Congrats to you! It surely is worth fighting for.

Hi there,

I am so glad to hear of your success. I was alos denied VSG, although I have Anthem BC of CA. I am goig to appeal it, though.  Any advice on whether I should do it by letter, include any supporting research, get my doctor to write something, etc.

I've scheduled my VSG already (in 2 weeks) so I am a bit in a rush. Anything you can tell me would be really appreciated.

Thank you in advance.