BCBS of ILL denied me

CuteDonna
on 4/27/04 4:43 am - Effort, PA
I called BCBS back in November, 2003 and asked them to send me the guide lines of what I must do in order to get approved for WLS. This is what they sent. 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. Now they send me a letter (see below) telling me that they need more information and saying it must be a year diet. I think something is little wrong with this picture. Don't worry my surgeon, Dr. Koren is fighting it for me and if need be I'll get a lawyer. BCBS Letter wrote: Documentation of Medically supervised weight management including nutrition therapy, supervised increase in activity, behavioral interventions and maintenance support. We would need 12 months of intensive medically supervised effort.
Lora H.
on 4/29/04 3:46 am - Kent, WA
Hi Donna, I got the same run around. Proved I had been on a medically supervised diet for 6 months, resubmitted request and now they say 1 year. I wonder how many people they do this to. Lora
CuteDonna
on 5/9/04 12:38 am - Effort, PA
Is your insurance with BCBS OF Ill also? I'm up in arms on what to do. Do I fight it or stick out the next 6 months and wait for them to turn me down again and then have to fight it. Donna
Most Active
×