Whoo Hoo!! BCBS of TX finally approved me!!

I can't believe it!! I won my appeal for the Lap Band surgery!! I just got my approval letter yesterday. I don't have my surgery date yet because I still have more tests to do before I can have my surgery. I am so excited!! Happy Dance!!!

Congrats I'm glad to hear that BCBS can be convinced. I'll do a little dance for you also cathy

BCBS approved something, I gotta dance too!

i was denied by bcbs of tx because of lack of info on 12 month supervised diet history..i have been on phentermine for 8 months and welbutrin for the past 6...any ideas how i should appeal since you made it? i appreciate your info. kat.

Kathy, I feel your pain!! I have been in the exact place where you are at right now with BCBS....But there is hope!! I also lacked the 12 month doctor supervised diet (according to BCBS had to be within the last two years) in my medical records. However, I had been taking the prescription diet drug Meridia from February 2003 until November 2003. After talking to a really nice lady at BCBS, she told me what to do since I lacked the adequate documentation needed for the supervised diet (she told me that my ducks were running all over the place....I needed to get them in a row!!). She said to get a copy of the prescription history from your pharmacist and also get your doctor to sign a letter stating that I had been on numerous diets for however long I had been seeing this doctor. The prescription for the Meridia didn't exactly cover the 12 months they needed....so I added that my doctor gave some samples of the Meridia at the beginning of the prescription. I kept taking it until December 2003. I also supplied in the letter my diet journal stating my weight loss during the time I was taking the prescription....It stated that I had only lost about fifteen pounds while taking Meridia. I called WalMart and they had my prescription history for the Meridia with the doctor's name prescribing it to me. I was able to get a copy of it and send it into my insurance. If you can get a copy of any of your receipts for the Webutrin and Phentermine....that would be great!! Then I typed up a very professional letter for my doctor to sign stating the diets I had tried while I was under his care from 1997 until 2003. These diets ranged from Weigh****chers, Jenny Craig, and diet medication that he had prescribed to me including Xenical and Meridia. I also stated in the letter all of my co-morbid conditions I have from high blood pressure, sleep apnea, high cholestrol, arthritis, and acid reflux. My doctor was so impressed with the letter!! He asked me if I wrote professional letters for my career...I'm not a professional letter writer....I just really wanted this surgery!! You can win against BCBS!! They just need the correct documentation to approve you!! There is no such thing as too much documentation!! I just found out yesterday that BCBS will also cover my fills!! I am about three weeks post-op from my surgery. I should be getting my first fill within three weeks. I heard the fills could cost between $100 to $250. BCBS will cover this cost!! Keep fighting!! Good Luck!! Linda

Linda, I just received my denial letter from BCBS of illinois today. I was so bummed-same as you the 12 month supervised diet--blah blah blah. Would you mind sharing your letter with me, as I think I am going to try to appeal? Thanks in advance. Cheryl