kaninag

SO-I got a letter from BCBS (the previous insurance that I had) and they denied me. The letter said that I had not had a BMI>40 for the last 3 years and I had no comorbid conditions. They said that I was denied. At the bottom the letter also said that my insurance policy had been cancelled as of Jan 1 (bc we changed to EmpireBlue). Anyway.....so now I am all depressed bc I just have this strong gut feeling that Empire is also going to deny me............AAAAHHHHH I HATE THIS WAIT!!!!!!!!!

I'll remember that next time.

Well, I have high cholesterol (BARELY) and arthritis in my knees but thats really it. Thats why I am so nervous about my approval.......

Well, I have high cholesterol (BARELY) and arthritis in my knees but thats really it. Thats why I am so nervous about my approval.......

Its like that in our office we always tell the patients that it is different with each individual case and we tell them that we wait for the doctors decision. They respect that better than us telling them how its gonna be and then the doctor ending up saying something totally different. I think all offices should be like that but unfortunately its not....insurance is the same way...i called today and the lady is like it WILL take 30 days for an approval...and I am thinking about alllll the ppl on here that go such fast approvals......INDIVIDUALITY!

You know these ppl at EmpireBlue are a lot ruder than regular BCBS ppl....I called today and I hit the wrong extension but I told the lady what I needed and she said she would connect me. Then she picked up and said that she showed that my information was sent to a case manager just yesterday and she was like it will take 30 days for a decision and I said well I still want to talk to someone in that department...and she put me on hold and came back again and said that she sees that I have been calling everyday and that if I am calling to see about a decision its not going to be ready because it takes 30 days.....I just hung up!!! I am soooo fed up with these ppl telling me that IT WILL take 30 days...not it coud take up to 30 days......they're really pissing me off and once I get my approval I am gonna send a nastygram!!!!

I got to thinking....the only thing i havent done is the psych eval.....my doctor waived it,.....does this mean the insurance company will too????

see I'm worried about getting screwed too bc my doctor waived the pysch eval........

*Sorry I guess its obvious that ppl at work are getting on my nerves;)

You know ppl who dont have issues with their weight def dont understand....I made the mistake of telling ppl at work and noone really said anything negative until the other day....and ever since then they have really been on my case....i am getting extremely annoyed and feel that i may blow up at them any second!!! eveyone is like youre crazy this is just the easy way out....blah blah blah...and it really pissed me off!!! THEY DONT UNDERSTAND!!!! DO THEY THINK ITS GONNA BE EASY DEALING WITH THE ANXIETY OF GOING INTO SURGERY...IS IT GOING TO BE EASY EATING AT DINNER AND HAVE EVERYONE ASK YOU WHY YOURE ONLY EATING ENOUGH TO FEED A MOUSE....and then when the weight starts to just flow off and ppl are asking what youre doing....I dont want everyone to know I have had the surgery you know.. .DONT THEY KNOW I HAVE TRIED EVERYTHING....I HAVE BEEN DIETING SINCE HIGHSCHOOL AND YOU KNOW WHAT I AM SICK OF IT I HATE COUNTING CALORIES AND I HATE NOT BEING ABLE TO EAT A PIECE OF CAKE WITHOUT IN THE BACK OF MY MIND THINK OH MY GOD THERE GOES MY CALORIE COUNT FOR THE DAY!!!! So you know what ppl who think this is the easy way out KISS IT!!!!

I guess no one has heard of, seen or used this huh???? I guess I just need to buy a couple of bottles online and see how they are.....I had been giving some proteinex that my doctors office said to use. It had 15g protein per 30ml.....I thought I better try it to make sure I could take it IT TASTED LIKE A$$!!!!I threw up....so ummmm yeah I gotta find something better than that!!

I am still waiting...we initially sent in all my info to BCBS about 1 1/2 weeks before Christmas....I called just about everyday.....my insurance changed over Jan 1---I didnt get an approval in time so on Jan 4 we resubmitted everything....Empire Blue is who I have now and they had everything in the system by tues this week 1/8...still no word....but hey that was just 2 days ago.... as far as dealing at first it was on my mind CONSTANTLY I was driving everyone around me crazy but eventually I settled down.....Its still on my mind but I cant run myself crazy constantly wondering about this you know??!!

Oh man thats great....I had the same thing with the office staff and my doctor was like nope you dont need this or that and because you have done so much research and are so prepared and know what youre getting into you dont even need the pysch eval.....so he put in his note that I was mentally ready....that saved me like $300!!!! It pays to talk with your doctor...but we have to realize the office staff are just doing what theyre told....

*cant you tell I am really nervous about getting a denial;)

Thanks bunches...that really makes me feel better has your BMI been greater than 40 for the last 3 years? Thats what BCBS requirement was but with Empire thats not listed on their requirement list:)

OH I AM SOO JEALOUS!!!!!!!!!!!!!!!!! CONGRATS THOUGH!!!!!!!!!!!!!!!!!!!1 Listen I am waiting still I submitted all my info...well 1/5 but they said they didnt receive it until this tuesday...but thats ok.....you give me hope due to your quick approval!!!!! WE MAY BE HAVING SURGERY THE SAME DAY LOL Listen can I be a little personal...if you dont mind what was your bmi and did you have any comorbidities???? CONGRATS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!:whoo::clap2::clap2::clap2::clap2::clap2::D

When I submitted my paperwork in dec they required a 6 mo medically supervised diet...so i think that is still the same

Get your cholesterol checked...if its high thats one co-morbidity.....any arthritis...chest pain, shortness of breath? Sleep apnea......Its worth looking into further....

Hoenstly I called within a couple of days to "make sure they received my paperwork" I'm glad I did bc that hadnt gotten anything on me....I called everyday.....didnt do any good time still ran out and I now have a different insurance company and have had to refile everything...but i just did the same thing yesterday....my doctors office "said"they faxed everything in on jan 2- I called Jan 4 and they hadnt gotten anything....so I called the drs office back....they were waiting on Empireblue to call back with a fax number bc they had never dealt with them before....I said look I got a name, extension and fax number....please fax today!!!

4Jin, Question....so if you're BMI is greater than 40 NOW even though it hasnt been for the last 3 years...they will approve you? See, BCBS gave me a hard time and said it had to be above 40 for the last 3 years or greater than 35 with 2 co-morbidities....but thanksfully EmpireBlue seems to not have a time frame requirement...

Thanks for the info. My case has been started with EmpireBlue..my doctors office has never dealt with them before so she really didnt know what to do...she called 1/2 and started a case on me and the nurse was supposed to call her back with a fax number so that they could fax my clinical info...they never called so i called.... got a fax number, nurses name and extension my doctors office was faxing my info TODAY!!!!!

I dont know anything about Cigna but BCBS will accept Jenny Craig and WW but you have to be going to see a dr at least 1x a month for them to monitor your progress....plus you lost 60lbs....thats a good bit...they might deny you saying that you can lose the weight without surgery...just a thought....

I was wondering that as well...cool deal I can add that to the list:)

Have all your doctors write a letter for you saying why they think you need the surgery...that will help

Ok, I can finally log onto my new EmpireBlue insurance stuff and I went under their medical policies and was a little surprised...NOWHERE does it say that you have to have had a BMI >35 for x amount of years....Regular BCBS policy does....This helps me (I think/hope) cuz CURRENTLY my BMI is 43 it has been over 35 for the last 3 years but not over 40...is this good...somebody please tell me if it not in their medical policy then it doesnt apply!!!??????