teamsters 710 bc/bs of illinois

hi, I have submitted my PCPs letter to my insurance company and we are just waiting for the surgeon to get his letter in, My pcp stated he supervised a 2 year diet plan. I called the surgeon, today, and they are saying it will be today or a couple days before he gets his letter faxed, because he is very busy, what is so hard. I saw him a week ago, and he said a couple days at that time. Bc/bs said once they get the surgeons letter, they will have an answer within 48-72 hours. Yes, I am nervous and anxious, I bet the insurance company and surgeons office are getting sick of my calls. But it is not them wanting this surgery very badly. Also, I informed bc/bs and the surgeons office, that whatever I need to get done so I can have this surgery ASAP, I will do, so I am seeing a psychiatrist for that testing, the doctors office and insurance co said I will be stuck with the bill if I get turned down, oh well. I will appeal. and pay the bill. Does anyone have anything to offer on this? thank you all!!

Find out if your union covers the Surgery. If not they may still cover the pre-testing and tell you at the last minute that you are denied. Self funded union plans that have exclusions are difficult to overturn. IF at all, it's usually done as part of a settlement deal. Talk to your union reps and also find out if they have approved anyone in the past. If the surgery is excluded and they have made exceptions you can try to use this against them. Good luck Gary www.obesitylawyer.com

hi, Gary, you are great, I have gone to your sight. That is where I got the example of the letter my physician was suppose to write to the insurance, I copied it word for word, and filled in my part, and my physician omitted, and submitted his part. He printed the letter that same visit, and I submitted it to bc/bs, called them to see if they had gotten it, and she remarked what a VERY GOOD letter my doctor submitted. YES, others at my husbands work had this surgery, and YES they do cover it, according to this company they look at the fact of the 35 BMI, and I am 35.3, and they look more at the necessity of the surgery, like the co morbs, I have degenerative disc disease in my back, leg swelling, GERD, depression, gestational diabetes, and both my parents have diabetes. I went to a psychologist, and that same visit he wrote a letter to my surgeon supporting my surgery, and that I am mentally mature, LOL!!! and so on. I am just waiting for my surgeon who is in the PPO, to write and fax his letter to BC/BS of Illinois, I visited him 9 days ago, and he keeps saying he is busy, and it will be a couple more days. I phoned bc/bs and they said my letter of approval, (I won't say the other) will only take 48-72 hours for a response. All I need to do is see a dietician, and I am calling Monday to set this up. And then lab xrays, and gallbladder ultrasound, and I am ready to go. I am sure he will write it, they said it is on his desk now, bla, bla. Hurry UP!!! If he was not a PPO I would find another, lol. thank you sooo much for helping all of us in need!!!!!liz