BCBS/NJ anyone?

Hang in there.  It sounds like you just got denied because of the 6 mos diet thing which for some reason it appears you were not made aware of. This process can be heart breaking at times, but it is worth it.  And you just HAVE to keep trying and doing what they want you to do. Did you submit all your weights going back to 99?  You only need 2008, 2007, 2006, 2005, 2004  Don't give them more information including weights from when you were much thinner.  It only gives them more cause to deny you. Yes, sleep apnea is a co morbid factor.  perhaps your doc didn't spell that out correctly.  So is the arthritis.  And actually, so is depression and social anxiety which can also be included.  Joint pain, arthritis related or not is also a co morbid factor. I used Barix - and although did not have to go through an appeals process, loved them.  And have heard from others that they are great at fighting for their patients.  I would call them as well and see what else should/can be done. Hang in there - it will be worth all the frustration in the end. Oh, and my approval took awhile - I think 4 or 5 weeks.  Worth the wait. If you want to talk to more of Dr. Boe's patients, hop on over to the pa board.  There's lots of us there who use Barix.  I'm a jersey girl myself, but use the pa board due to the high activitiy rate and the number of people who have had experience with Dr. Pupkova and Barix Pam

I also have NJ BC/BS (Horizon though) they were a B*&%% to say the least. I have to say just don't give up!  It is very frustrating, but after several denials and appeals (the last through my employer) I was finally approved and it has been well worth it. Linda

Hi Vicki Don't give up!   It took me over two years from when I first started!  Part of that was I met with one doctor & jumped through all the hoops only to be told by him that he would not do the surgery.  Once I found Dr. Garrison things definately improved but I still had to get past the insurance company. Many of them still want the 6 mos (or more) diets.  I think the best bet is to find out EXACTLY what the insurance company requires.  Mine had a website where I could print all the particulars.  I took that to my primary and walked through it with him so he could supply what was needed.   The surgeon's office might be helpful too.  They do this everyday and know what is truly required.  Talk to them too. But Don't Give Up!!  It may take awhile but it is worth the effort and aggravation! Hang in there & send me an email if you feel like talking! Vicki

Hi Vicki, I didn't have to jump through the hurdles you have, but I can understand your feelings nonetheless, don't give up hope, as Pam said, Barix is a great place to have your surgery, the surgeons there are top notch and the facility and it's staff will do all they can to help facilitate your getting approval.  You can try calling the Insurance Company, but I'd give it at least a 2 week period before I started with a phone call to check up, I just can't imagine them turning you down with all the factors you have.  So have faith, you might have to fight a little longer (as you've done), but it will be so worth it and also, as Pam said, the PA board is a place where lots of folks that have used Barix hang out.  While I live in NJ, most of my support comes from there and a board of my peers (the Over Fifty Forum), as this board, while there are lots of wonderful folks, is not quite as active. No matter what, I wish you a successful journey to healthier living!

Thank you all so much for your encouragement!  I am doing my best to keep my head up.  Doesnt always work. 

I got a call today from BCBS and they wanted to let me know they got the appeal paperwork (on Friday, I was told it was sent in weeks ago)  and wanted to know if I wanted them to go ahead with it.   UMMMMMMMM huh maybe let me think about it.

 DUH YES!!!!!!!!!!!!!!!!!!!!

What kind of question is that?? No I just sent in my appeal for hahas.  But now I am even more nervous, I am going to call them again tomorrow AM and see where I stand...hopefully I am standing closer to that Loser's Bench!!

Please think of me and if you believe PRAY for me.  And if not for me for my 2 little kids to have a mommy that can do things!!

Honey you know I'm praying for you & crossing my fingers lol.Remeber what I said you deserve this & you deserve a long healthy life & it's gonna happen.Keep me posted

I GOT APPROVED!!!!!!!!!!!!!!!!!!!!

CONGRATS!!!!!!!!!!!!!! 

YOU ROCK IT GIRL!! I am sooooooo psyched for you - possibly even more so than I was for myself last year!  LOL  Way to work it!  All your patience, perserverance paid off! Pam

Congratulaitons Vicki