Blue Cross/ Blue Shield Tennessee

THEY STINK!!! I would have used a stronger word, but, I didn't want to offend anyone. I got a Pre-Approval letter in October so we set everything up and I got the pre-op testing done, and had the appointment set for the surgery. November 25, 2003 was to be the big day. On November 20, I got a phone call from the doctor's office, they denied the authorization. HUH!? Of course no phone calls since that day have been returned, and the letters that have been sent have not been answered. The only answer I could get out of them was "it isn't in your contract". Well, let's get it there! I wanted to know what to do to get it added, who to talk to etc. I'm mentally and emotionally drained from all of the fighting I have been doing... there HAS to be an answer...

Melissa, Have you received a denial letter yet? Have you read your policy through and through to see if WLS is an exclusion? Don't ever take their word over the phone for anything. Everything must be in writing. Also, even if "treatment for obesity" is an exclusion, you still may be eligible as treatment for another co-morbidity such as Diabetes or Degenerative Disc or Joint Disease. Don't give up. Roberta