Blue Cross Blue Shield definition of medical neccessity

I spoke with Blue cross Blue Shield of Illinois today. They have denied me because surgery is not the best treatment of my morbid obesity and not a medical neceesity. Their deinition is:"a specific service provided to the patient required in the reasonable judgment of BCBS for the tratment of a medical/dental condition. The service provided is the most efficient and economical" They seem to be in the dark ages-Jane [email protected]

This can easily be fought and won. The NIH states that gastric bypass is the best option for the morbidly obese who have been able to lose weight on a low calorie diet. Do you have co-morbidities? Have all of your doctors write letters stating that surgery is necessary to treat your life threatening conditions. Fight the Good fight! Roberta

Fight them and don't give up. Keep sending letter after letter. ALWAYS put everything into writing. Do you have any medical problems? Donna in PA