Great news?. I check BCBSIL procedure web site every few days to see if it has been updated for the sleeve ? and it has been updated today.

I could not find the words "investigational" with "sleeve" - If I'm reading it correctly - VSG is now accepted....

I was a few weeks too early - I was denied and approved after I did the appeal...

OMG I HOPE You"re Right... maybe my doctor not being on the ball is a good thing! I've been done with my 6 month diet doc which was the last thing I had to do but it is taking my doctor forever to get the info over to my surgeon so that I can send it in again! I just want to get approved and scheduled!! I lost 40 lbs on my 6 months but have been eating out of frustration and anxiety and put 5 back on! I just want to know if I am going to have to appeal or not!

wow 6 month - The BCBSIL requires a 3 month supervised diet and your BMI number they consider is your initial one:

"Documentation of active participation in a comprehensive, non-surgical program of weight reduction for at least three (3) months, occurring within the twenty-four (24) months prior to the proposed surgery. (NOTE: The initial BMI at the beginning of a weight reduction program will be used to meet the BMI criteria for the definition of morbid obesity used in this policy.) "

Lou

I'm so hoping that Wellmark BCBS of Iowa will hurry up!!!!!! My patience is wearing thin!!!!!

I know Lou but my stupid employer Walgreens requires a 6 month...I have been pretty bitter about that for the last 3 months!! but its over now hopefully my surgeons office will get it submited in the next week!

wowo that is great news with BCBS for you hope it continues...

:001_wub: :001_wub: LOU, I THINK I'M IN LOVE WITH YOU!!! :001_wub: :001_wub: :001_wub:

How nice of you to keep checking for all of us BC/BSer's out here who are waiting to get approved by them.

I have my psych evaluation tomorrow, along with my second visit with the nutritionist.

Then I have to get my butt to two more support meetings (July 26th & Aug 23rd), one more visit to the nutritionist and one with an internal medical doc (required by the surgeon) both on August 20th. Then my packet should be sent in to the ins co. Woo Hoo! :thumbup:

Do you have by any chance a link to their actually converge?

I see they have a flash on the decision making but I would like a text since I have Anthem BCBS and they denial and I am appealing.

I will like to attach they policy to my appeal letter.

Thanks,

home page : BCBSIL/Provider Medical Policies on Fyiblue

then i search for "sleeve"

then "Bariatric Surgery "

Lou

i got it, u r right, i didn't scroll down to accept the rights, this is why i couldn't search. Thanks for the quick reply.

You could also send them BCBS ND's new policy approving the sleeve with your appeal--but I got the info on the phone and don't know where it is on the web.

Donna, thanks i found it. u just had the surgery a week ago? How r u feeling?

hey guys.... just thought I'd let ya know that I finally got my approval from BCBS IL! they actually denied me based on investigational even though they changed their policy and I had to call them and tell them the policy had changed, 6 calls later they finally approved it!!

This is the only information I can come up with for myself. I have Anthem bc/bs of Ohio-Blue Access PPO. I don't know if this link will work.

SURG.00024 Surgery for Clinically Severe Obesity

This states that the sleeve is still investigational and is not covered. I just don't know if this is the current status for Ohioians. ?

Jeannie,

You r right, this is the policy, they didn't update it since January.

I am going to appeal today.

Did you got approved for VGS?

My surgeon has not submitted my paperwork yet. I have to do the 3 month supervised diet and that won't be complete till the middle of Sept.

Do you have BC/BS of Ohio too?

My surgeon said he has had a gal get approved for the sleeve and I don't think he even had to appeal. I think it's how he requests the sleeve when the paperwork is submitted. He does alot of explaining as to why the sleeve is the best choice for a particular patient. He's already told me that he does not want to do a GBP on me. If he was forced to, it would have to be open not laproscopic due to adhesions. YUCK!

He going to explain that my previous surgeries make the sleeve a safer surgery with better outlook for weight loss. Also, at age 58 the malabsorbtion is alot bigger issue!