Question:
BCBS!I was wondering how many people are having trouble getting approved with BCBS?
Hi I have BCBS of AL, PPO. I have heard from a few people that BCBS is now denying all Surgeries. Has anyone else heard this or experienced problems? Does anyone out there have my Ins, if so please post so we can chat! thank you MAY ALL YOUR SURGERIES BE APPROVED! — nicole79 (posted on May 27, 2002)
May 27, 2002
Hi, I have BC/BS PPO in Connecticut, and have had no trouble in getting an
approval. My surgeon sent a letter of recommendation following the psych
evaluation and nnutritional evaluation. He asked me to enclose my history
of dieting , weight loss and health problems related to obesity and 6 days
later it was approved. I would callBC/BS and ask if your policy has any
exclusions. Then see if your Doctor is going to handle the initial
insurance letter. Good Luck and safe journey.
— Elizabeth P.
May 27, 2002
I have BCBS of Vermont. I had no problem getting approved. The surgeon
sent a letter in stating medical necessity and I was approved in only 3
days. I would call BCBS if I were you and ask some questions. Good luck.
— Brenda A.
May 27, 2002
HI I have bc/bs ppo and i was approved the very first phone call and i was
considered a light wieght at 250 . I had no problems with them and i only
had to pay 100 dollars of my own money on the surgery costs :-)))) Good
luck
— sallie P.
May 27, 2002
I have BCBS of Delaware and had no problems getting approved (and I fully
expected to have problems; I am a lightweight at 218 with several
co-morbids, which is I guess what did it). Anyway, I received written
approval two weeks after the first letter was submitted. This was only a
short while ago (my surgery is scheduled for next Monday, June 3rd). Good
luck!
— Melissa S.
May 27, 2002
Please don't confuse BCBS paying for surgery with pre-certifying or giving
written approval. My provider, BCBS of MI, at the time of my surgery, sent
letters around that they were no longer 'pre-certifying' or issuing prior
approval surgery. What that meant is that it had become so common that
pre-certifying was no longer necessary. Just like with my recent breast
lift, pre-certifying is no longer necessary as long as the surgeon gets
500g of flesh per breast. Hope that helps...
— merri B.
May 27, 2002
I have Horizon HMO BCBS of NJ. I worried about getting approved with an
HMO, but they came through in only 4 days! My total out of pocket costs
came to maybe $150 including my phone and TV rental at the hospital. I wish
you the same good fortune.
— Donna L.
May 28, 2002
I have BCBS/AL. I had recieved 2 written letters of approval before my
surgery. However, the other day I received 2 different bills (one from
surgeon and one from hospital) saying BCBS denied payment. Saying it
wasn't a covered benefit. Of course I called the insurance company and
they said they would resend the claim. I didn't have a problem with
approval just a problem with payment.
— Deanna H.
May 28, 2002
Hi I have BCBS PPO of Tn and I was turned down last Thursday but I intend
to appeal and get an attorney if I have to because my life depends on this
surgey the dr told me that I will not live long with out the surgery, so I
pray that all gets approved and please keeep me in your prayers
— Ann P.
May 28, 2002
I think it all depends upon which BC/BS you have. My wife had BC/BS of
Michigan, BMI of 45 and no life threatening comorbidities, and was approved
without any problems whatsoever. I have Anthem BC/BS out of Indiana/Ohio
and they were a nightmare saying it wasn't medically necessary. This
despite my starting BMI of 63, severe sleep apnea, high blood pressure,
High Cholesteral and Triglycerides, knee, ankle and back problems and being
borderline diabetic. I eneded up having to hire Walter Lindstrom to get me
approved. So it all depends upon the policies of your specific BC/BS.
— Dell H.
May 29, 2002
Hi, I have BCBS of FL PPO, and they denied me because I don't have one year
of medically supervised dieting, my bmi is 48, and I have alot of things
wrong with me because of being overweight. I see people asking about BCBS
all the time in the questions and answers, so IM not alone. I hired Walter
Lindstrom to fight my appeal, now Im waiting. Good luck to you. Melinda.
— melindameyers
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