Second appeal denied!!!

Karen W.
on 2/12/05 12:25 pm - Shreveport, LA
Just like Beth I got denied but for the second time also with BC/BS of Alabama. The first time I got the very same letter that Beth got stating no documentation of 3 years of being obese and documentation of a 6 month diet with one of the months being at least 6 months before requesting the surgery. MY PCP wrote a very detailed letter stating I have been obese for 12 years and wrote all the different diets I had been on which none worked. I called them on Thursday they said we still do not have a decision. I called yesterday and got the news Denied!! Due to no documentation ... blah, blah the same as before!!! So, today I got the letter from them why I was being denied. ( Sure was a fast letter since Thursday they knew nothing huh?) Now they state they can not accept a letter from a doctor but only my medical records. And before when they told me it could be a letter from WW or Jenny Craig now they won't even take my doctor's letter??? Is this abnormal asking for the medical records and the diet has to be in there? Or do they accept the letter from the doctor??? IF Gary reads this do I have a case or go to the doc and start a 6 month diet? Thanks, Karen
Beth G.
on 2/12/05 1:46 pm - Pelham, AL
Hey Karen, It would be great to hear from Gary about this. If you hear anything let me know. I bet there are many others in this situation with BCBS of Alabama. It just isn't fair. Please keep in touch. Beth
CuteDonna
on 2/12/05 9:18 pm - Effort, PA
I went through this with BCBS of Il but I had to have a year of dieting under my PCP with NO breaks. I never missed a month of seeing her. Donna
livinglife42
on 2/17/05 9:40 am - HOOVER, AL
i want to know if you only have documention of your 6 months supervised diet and no other diet you have been on in the last 2 yrs prior to requesting surgery and you have been morbidly obese (100 lb) over weight in the last 3 to 5 yrs do you think bc/bs will approve me?
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