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Bcbs Of Al Being Lazy!

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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  • Lori Voss Green
    Lori Voss Green

    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 requi

  • Thanks everyone. I just hope i can stick it out at my job long enough to get approved! Ugh! I just dont know how to get the documentation they want. Ive never really seen a MD type doctor on a regular

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Yeah, that's one thing I have a hard time understanding. So many companies EXCLUDE weight loss surgery. WHY!? Weight related health issues surely cost more in the long run than the surgery.

dont give up !!! I have BCBS too, and last fall they approved me in 3 weeks ! I had a letter from my dr stating that she felt i was a good candidate based on my family history , (short women with weight probs), and i had tried 1 yr of weight watchers w/o success, plus i had high BP and sleep apnea. my bcbs paid 100% (bless them), i was banded last December, ive lost 50 lbs and im very grateful to them for paying for the band. I was told to just jump through their hoops and get all the proof, letters of recommendation, and documents signed that i could. i did everything , had the paperwork sent in a nd got approved quickly. So hang in there and keep trying !! Dont give up !!

I agree with the don't give up aspect. It was 8 months for me from start to surgery and my insurance put me through every hoop possible.

I stayed focused and provided them with everything they asked. I am now one month post op and so glad I kept fighting for this.... I am very happy with my decision.

Best of luck to you and....yes you can...be strong.....don't give up.... you are worth the fight!

  • Author

Thanks everyone. I just hope i can stick it out at my job long enough to get approved! Ugh! I just dont know how to get the documentation they want. Ive never really seen a MD type doctor on a regular basis and apparently the one i did see didnt make notes of my weight loss attempts. Thanks a lot! So im at a loss. Just waiting to hear what my case manager wants me to do. Trying to stay strong but its hard! :/

Are you being asked to perform the 6 month weight loss program?

If so, call or go on line to your insurance company and obtain their preference for this process. Know all the details then tackle them one at a time.

My surgery center assisted with the 6 month weigh in's, suggesting a NUT ...make the psychological evaluation quick those can take some time. Good luck and don't give up!

I have BCBS AL waiting on approval for VSG they've had all of my paperwork 3 days so far and its a lot but its all there. Hope and pray I get approved by the end of next week!

  • Author

Starting Over - I did 8 months of Weight Watchers but the problem is the doctor I was seeing at that time made no notes of it. I was seeing him every 3 months for 2 years. (over a year before i got pregnant and during the pregnancy) And he never made any notes about my weight loss attempts. There is no documentation from an MD that says i was on a weight loss program. My midwife and naturopathic doctor have all kinds of notes in their paper work but BCBS doesn't accept these because they are not from a Medical Doctor with some fancy degree!! it is so frustrating that the information is right there for them to see but because it isn't the way they want it I am denied! SO FRUSTRATED!! wish i knew a doctor that could make some notes on some paperwork for me! hahahaha! oh well

Insurance will not take weight watchers notes or payment receipts?

It seems like if you have the documentation you should be able to

challenge the insurance decision. Best of luck to you...keep looking to

find a way if this is your decision! Don't give up!

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