I AM DENIED AGAIN!

What is up with BCBS. I don't understand! I pointed out to them that I meet all the criteria for the surgery under hteir guidelines. I just don't get it. What more do they want? I am getting very frustrated but I am not going to give up. I have already sent my letter for the 2nd level review. Has anybody else been denied on the appeal? If so, what did you do? Any information will be helpful.

Sorry to hear you're having trouble getting approval--that is my #1 fear! What kind of BCBS policy do you have? Kerri

Focus on what they have denied you for. Becuase they can't come back and find something else to deny you for. I have know people to fight after 2 denials and won. So stay with it and focus on what they say they have denied you for. Good Luck!!!!

I was denied 3 times before I got approved. All you can do is appeal. When I did my final appeal I included additional letters from my different doctors that all supported me having my surgery. Good luck!

What kind of BCBS policy do you have? I have BCBS of NC - the PPO policy with 100% paid after the $250 deductible (my own individual insurance, not through an employer). Mine was approved the first time with no problems and I had my surgery on August 14th. BCBS has been phenomenal communicating with my surgeon and only asked for one follow up test before approving the surgery (a test for the h-pylori bacteria). Is your insurance through an employer? Maybe the employer doesn't include the WLS wording in their policy in which case you may have to address this with your employer. Robin

Dont brag on BCBS of NC too much. Ive been bickering with them for months. Phenomenal? PLEASE!!

I'm not really sure why you felt the need to be sarcastic to me. I was stating my own experience which was quick and, yes, phenomenal. BCBS-NC worked very quickly with my surgeon's office to get me approved and I've had no problems whatsoever with them. Of course my surgeon's office was top-flight and knew exactly the kind of documentation BCBS would require and helped me get it all together before submitting. Once submitted I was approved almost immediately and had a surgical date within 3 weeks.

Robin, Never would I intend to be sarcastic to you. Im in the middle of my own struggle with BCBS, and when I saw you call them phenomenal, it perturbed me. Yours was phenomenal, and mine wasnt. Take a chill pill. Steve