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Bcbs Of Al Being Lazy!



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What a bunch of lazy people. We submitted ALL of my paperwork and whoever reviewed my claim just looked at the first page and denied it. They said I needed to give them the H&P and 6 months of supervised nutrition classes and I told them it is all there in the paperwork. So I called my case manager and told her what they said. She called them and went page by page. Writing down what page number all the info they wanted was on.

Now it has all been RE-submitted and now I am waiting AGAIN!!! You would think they were capable of turning a few pages! Geez!

Ok Rant over.

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BC/BS is the worst. Both daughters have it through work and they have to fight for every claim. Even 35yrs ago when I worked in a Drs office they were a pain.

I believe it's a stall tactic they're required to do on all claims.

I have Aetna and have never had a problem, knocking on wood...

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I work at BCBS of IL and all of the BCBS companies are different. It sucks that you are having such a hard time getting approved. I don't know about the other companies, but BCBS of IL no longer requires the 6 months of nutrition/Weight Watchers/etc. I am seeing an increase in members getting approved and getting approved quickly.

I hope your BCBS gets on the ball for you and you are able to get approved quickly. It's definitely frustrating to have someone/something keeping you from your goal. Good luck!

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Its just frustrating that they had all the paperwork they needed right there and couldn't seem to see all the information! I could have been approved already! sigh.... it just seems like every day that goes by is one more day I have to suffer. I know it will be approved eventually but I am so impatient! lol

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Oh, I do not blame you at all! I work there & I was impatient, calling constantly to check on it! I was actually approved in May but couldn't take the time off for surgery until August, so I knew there was no rush on my approval, yet I was checking in all the time until I got the word that it's a go. After all this is OUR health we're talking about.

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Exactly! I mean its not like they didnt have the paperwork. They did! All they had to do was LOOK AT IT!!!

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I have BCBs Al also. they did the same thing to me and now my husband. I called several times a week and sent emails. I think they finally had enough and aporoved me on the peer to peer review. They didnt even look at my husbands info either a.d they got all of our info mixed up. They put my husbands name on my authorization.

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Its ridiculous! I called them today and after nearly 10 minutes on hold the guy came back and said it was still being predetermined. I plan to call every day until i get an answer!

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I threatened to get the insurance commissioner involved...

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Hopefully I wont have to take it that far. I am so ready to do this and start moving my life in a new direction! Impatient doesnt even begin to describe how I am feeling! :D

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I hope you weren't on hold for 10 straight minutes without the customer service/advocate checking in with you! If we did that, oh would we be in some trouble! That's not good customer service at all. Sadly, I do know (at least where I work) that the department doing preauthorization has 30 days to review everything since they have so many things they work on. I rarely see it take that long. Hopefully they get it together and get your approval to you ASAP!

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Well when i called yesterday they said it was denied because in all of the 184 pages of medical history there wasnt enough documentation from a "doctor" saying i was on a weight loss plan supervised for 6 months straight! My WHOLE LIFE has been a weight loss plan!!! After i got off the phone i cried and cried and screamed and screamed! I am so disappointed, sad, and just beaten down. The worst part is that the possibility of this surgery is the ONLY THING keeping me at my current job. I need the insurance to get my surgery but it is a hostile work environnent and i dont think i can tough it out for another 7 or 8 months. :( :( :( Im at the end of my rope from every angle. I guess I'll see what my surgeon says.

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:(

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This was my biggest fear. I was so worried about bcbs turning me down because I didnt have a 5 year medical record of my weight. I went to True Results and I got results. Three months from time I walked in the door I was in having the band put on.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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