Why does BCBS of IL have 6 month and 12 month requirements?

My doctor submitted a letter of medical necessity to BCBS of IL for Gastric Bypass surgery and included a long 5 page letter detailing co-morbids and why I felt I needed the surgery. Anyway, I haven't been denied, but I received a letter saying to complete their review they need visit notes from md supervised weight reduction program from the last 12 months and nutritional counseling. I do not have these because my previous pcp never brought up a specific regimen with me. I know my weight is documented at least 3-4 a month for several years because I have severe problems with asthma and I was in the pcp's office several times a month. She would only ask me once every few months was I excercising and we would talk breifly about my eating habits, but nothing more than that. Anyway, why do you think they need 12 months from me while I read other posts that say BCBS just asked them for 6 months of supervised diet? I called and asked them for their explanation of benefits or their requirements and writing and they assisted they don't have anything to give me and she stated that the medical review board makes the decision for approval or denial. Should I hire a lwayer now or wait and possibly waste time and why do I have 12 months opposed to 6 in your opinion?

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