BCBS Of Illinois

I'm wondering if anyone has ever heard of having to be on a supervised diet under your PCP for a whole year? I got a letter dated November 6, 2003 from BCBS stating that I only had to do 6 months of dieting and now they are telling me a year. They are going to be sending me out another letter with the correct information on it. I think this is real unfair to me. Some people have told me to fight it with the first letter

Hey Donna, I have the same insurance and was denied on 01-14-04. They want me to do the same thing like I have not tried everything already. I even wrote a 6 page letter that was sent in with my medical records. and was still turned down. Everyone says to fight it. I don't know about you but I feel like thats what I have done all my life. Now I have the chance to get help and they won't give it. They sure want the payment when due to them but screw us when we need the help. Please stay in touch . You can e-mail me @ [email protected] Signed Lets fight! Leslyn Chitwood

Why where you denied??. Did you go through the 6 months of dieting? I'm going through every step they ask me to do so far and my letters (4 of them) that BCBS sent states 6 monts of notes from PCP on deiting. This what all the letters say. MD evaluation with patients presenting complaint. Height/weight. BMI, list of diet history and excerise programs with results, 6 months medically supervised weight loss notes. Don't give up. FIGHT THOSE JERK Tell themt that's a on turning you down. Donna in PA

You must absolutely appeal the denial based on the information provided to you in your first denial letter. Insurance companies are playing this diet game to try to get you to quit, and give up. Don't let them win. It's just a stalling tactic on their part. Fight the good fight! Roberta

I have the same insurance and am in insurance hell at the moment. I had my surgery last June. Surgery was supposedly preapproved by surgeon's office, I have a letter from BCBS with a confirmation number for the precert. They are now telling me that I was only precertified for the hospital stay, not the surgery (??). When I originally called in Nov. 2002 to ask their requirements, I was told that eligibility is determined on a case-by-case basis. My surgeon's office, who is an in-network provider, makes prospective patients jump through all kinds of hoops before even getting to the insurance approval stage, which they totally handle. My surgeon assures me there must be some kind of paper snafu, but BCBS is telling me It's my burden to prove that. I do not have the 1 yr. medically supervised diet and exercise program that they are now insisting I need documents for, because--like all of you--I have been on one diet program or another my whole freakin' life.....all doctors tell you is "you need to lose weight. Diet and exercise." DUH! The surgeon has left the center where I had my surgery to set up his own practice, the office manager (whom I believe is responsible for this mess) has married and moved to Florida, and soon I will have a collection agency breathing down my neck! BTW, BCBS DID pay all of the hospitalization, preop testing, post op visits if that makes any sense at all. "Just" the surgeon's bill, his assistant, and anesthesiologist fee are outstanding----around $25,000. !!! OY! This girl will be looking at legal counsel soon, if anyone has any suggestions. Oh, I've been able to lose 82 lbs in the past 6.5 mos.....maybe they want me to gain it all back????

Julie, I'm sorry they are jerking you around like this. So what your saying is that they gave the OK without the diet and now want you to show proof? That is not RIGHT!! Maybe you should get a lawyer and fight it. Remind them of the paper work they sent you Donna PS: Leslyn, I'll keep your email address and let you know how it goes for me in April. I'll probably be turned down also. Keep my email [email protected]