Question:
what does bcbs/fl ppo/blue choice look for for approval?

i have a bmi of 51 i have high bllod pressure and enlarged heart i have proof been seen by a doctor for high blood pressure since 1994 but that dr. i have seen from 94 -96 destroyed my medical records already but i have proof from the dr. i went to right after him that has my records of med. supervised weight loss meds. etc.. hes going to give me a recommendation letter also just found old reciepts from walgreens that has the dr. from 1994-96 on them and the blood press. meds.+ anti depressant med. on them they date from 94-96 and a obgyn i seen in1999 after misscariage is going to write me a recommendation letter also cause he advised me not to try and get pregnant again until I lost weight do you think that is enough proof for them? Please let me know thank you for your support in advance.Also my dr. i just recently saw that told me i have an enlarged heart is also going to write me a letter and i also wrote down all diets i have been on since after the birth of my daughter at age 19 and that was 12 yrs. ago. I hope that is enough please let me know Thank you.    — Kelliann S. (posted on September 1, 2002)


September 1, 2002
I have BCBS of TN - PPO. They asked for me to be 100 lbs over weight, I had a list of diets I had been on - typed by me, and records showing I was diabetic and had back problems. I got approval in two days. (the second time, the first time the doctor sent in the wrong code.) Good Luck.
   — Pam G.

September 1, 2002
I have bcbs ppo blue choice of florida they will try to hoodoo you anyway they can---wls is a covered benefit--I have met all requirements--they would not accept 18 months of a commercial weight loss program--because it wasn't dr. supervised I hired obesitylaw and I should have an answer from them in a week--customer service for these people is what I call Dumb and Dumber
   — Linda L.

September 1, 2002
I, too, have BC/BS PPO of FLA and they were FABULOUS about approving my WLS (open distal RNY transected 8/14/02). They were quick and cooperative and friendly and very supportive. I gave them a well-documented, typed schedule of weightloss attempts, one of medically supervised attempts and one of non-medically supervised attempts. I listed my age, height, weight, type of attempt (Weight watchers, phen-fen, etc...) time on the diet and weight loss in pounds. If the attempt was medically supervised or via an established group (ie: Jenny Craig) I included their name/address. I figure that the insurance company could pursue further info/documentation if they wanted it. Good luck in your WLS journey!!
   — Rebecca T.

September 1, 2002
If you are not sure call the customer service # to find out what is required. I believe it is : 100 Pounds overweight, 12 months of a medically supervised diet, Psych. Eval. I have heard that in 2003 BCBSFL will no longer cover WLS unless your employor buys a rider to cover it. So you may want to speed up the process. Good Luck Good Luck
   — Sharon H.




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