LORI FROM BIRMINGHAM ALAB...

LORI FROM BIRMINGHAM ALABAMA. I HAVE BEEN TRYING TO HAVE THE GASTRIC BYPASS SURGERY SINCE MAY OF 2004 . I CALLED MY INSURANCE CO. AND THEY SAID THERE WERE NO EXCLUSIONS. BUT AS TIME WENT ON I HAD TO GO THRU HECK AND BACK AND AM STILL THERE. I WAS ON WEIGH****CHERS FOR 6 MONTHS AND BCBS PPO SAID THAT THAT WAS ACCEPTALE THEN THE DRS. OFFICE I AM GOING THRU FAILED TO SEND IT IN BEFORE THE 15TH OF OCT. NOW THEY SAY THAT I HAVE TO HAVE 6 MONTHS DR. SUPERVISED VISITS. I HAVE BEEN DENIED 3 TIMES . NOW I SENT ALL OF MY PAPERS TO OUR HUMAN RESOURCES AS THE LAST STRAW. IF NOT I WILL HAVE TO GO 6 MONTHS SUPERVISED VISITS. SO IF ANYONE CAN OFFER ME ANY HELP I WOULD APPRECIATE IT. BUT ONE LAST THING THE ONE THING THAT BOTHERS ME IS THAT I KNOW OF PEOPLE THAT HAS HAD THIS SURGERY NO PROBLEMS AND HAS BEEN ABLE TO HAVE IT NO QUESTIONS ASKED ME I HAVE LETTERS FROM MY CARDIOLOGIST BECAUSE I HAVE HIGH BP, HIGH CHOLESTEROL, ACID REFLUX, SLEEP APNEA AND POSSIBLY DIABETES .

If the Doctor failed to submit the paper work for Weigh****chers then why not just have the Doctor submit it again now to get you approved? Why is October 15 a magic cut off date, did your policy change all of sudden to having 6 months of supervised diet under you PCP? Insurance companies don't care about your health. They want you to fallow those guidelines that they lay down to you. Donna Donna

ACTUALLY THE 15TH WAS A CUTOFF THEY WEREN'T PERFORMING ANY MORE SURGERIES AND THAT CAME FROM BLUE CROSS. THE DRS. OFFICE SENT IN MY WEIGH****CHERS BUT AFTER THE 15TH BCBS WAS BRINGING IN NEW GUIDELINES THAT IS WHERE THE 6 MONTHS DR. SUPERVISED VISITS CAME FROM. AND IN MY BENEFITS BOOK IT STATES THAT OBEISTY ISN'T COVERED BUT SURGERY IS ONLY IF YOU ARE TWICE YOUR NORMAL WEIGHT. THAT IS WHAT I MEAN WHEN I TALK ABOUT A CUTOFF ON THE 15TH.

Then do the 6 months of dieting. 6 months goes by pretty fast. A year went by fast for me although I must admit I wanted to pull my hair out and along with everyone that worked for BCBS of IL also Donna

I AM BUT I AM ALSO SENDING MY PAPERWORK TO OUR BENEFITS PERSON. I WAS TOLD THAT HE COULD OVERRIDE THEIR DECISION.

Lori, How about joining us on Hwy 280 on Feb 3rd at O'Charley's. You will get a lot of advice there. If you read my profile, you will see that we are experiencing the same problem. It would be great to meet you. Beth