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BCBS Fed response...

My WLS doctors office submitted for pre approval for lap band last week. Saturday I received a letter saying it was denied. It stated I lacked documentation of per and post - operative nutritional assessment and counseling. My WLS doctor sent me to a nutritional class back at the end of Nov.

Anyone else have nutrition counseling? I have a call into the dr but just waiting on a call back.

Thanks!

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Featured Replies

my advice fight I mean get you're claws out and start fighting first call you're insurance company and Dont I repeat talk to the agent talk only to manager get ext # as well because they will do anything not to pay my insurance said because I had no insurance since 2010 I asked Thats funny I have a 2 yr old and yall paid I wonder how that happened so no matter what stay strong and postive and Dont give up

"We have BCBS Fed too and I had to go through a couple of things with them wanting more documentation from my surgeon's office. Fortunately, the insurance gal at his office is really good about making sure the insurance company gets every detail they ask for, so my paperwork finally made them happy and they covered it 100%. ........."

How did you get them to pay 100%? My BCBS fed'l only pays 85%?

Hmmmm, not sure why the difference, unless we have different levels of the plan? The fills have not been covered 100%, I think those are at 80%, but the surgery and hospital, etc. were all covered.

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