Denied AGAIN with BCBSIL

[gfawcetti 13]

I got so disgusted with BCBSIL. When they denied me the 3rd time, I was about to cry. I called & didn't like the 1st customer service rep. I called again & got the nicest guy. I explained that my frustration was when I had my doctor fax what they wanted, next time I was told they wanted other things. I asked him to call medical review & tell me exactly what was holding up my approval. He told me & my dr again sent a fax. I was expecting to have to call the rep back b/c he had given me his ext but I got a nice surprise when he called in the am to say I was approved. Just hang in there & don't give up. Call them every day following any new faxed information.

Jan

You don't happen to have his name & number still do you?? LOLOLOL I liked the lady I talked to today & she did call and talk to the nurse so I know what they want now. I do think that she was getting a little frustrated with me and all my questions though... I just wanted to be sure so that I can send the right stuff, ya know... I am by no means giving up, I will call and bug them until they approve me... I just want to do it in Nov because that is the best time for me to be off of work.

Glenna

[+change 5]

I remember the rep's name was Clay but I threw away his ext #. Sorry I can't be more help. I wasn't saying LOL after my 3rd denial....I was on the warpath! Hope you get good news soon. Jan

[gfawcetti 13]

Oh, I am on a war path, but I am trying to do it with a smile... next time I call in I'll ask for him

[+change 5]

You are right to keep smiling. You won't get anywhere being unfriendly to an insurance rep. I will be praying for you to get approved soon. Take care, Jan

[gfawcetti 13]

Quick update... I talked to my Dr today & I think she called BCBSIL, have I told you all how much I LOVE my Dr! Then she wrote a letter for me that explains that I was on a 1200 cal/day diet with excercise. It also states that I have daily food journals & exercise logs and I came in every month for a progress check. I was able to loose 10 lbs during that time. I also wrote a letter to send to them from my heart about how this will change my life & my family life; I inculded that my dad has HBP, Diabetes, High Cholesterol & had a stroke at 59, also that my mom has HBP, High Cholesterol etc.

I am really hopeful that between that, the proof that my BMI was over 40 (40.8 to be exact) when I started my MSLWP, and a description of the program my Dr had me on will be enough to get this thing moving!! Can you think of anything else I may need??

Also, why does the info always come in on Friday when they aren't open till Monday?? Patience!!! Thanks for reading this very long & rambling post )

Glenna

[+change 5]

Quick update... I talked to my Dr today & I think she called BCBSIL, have I told you all how much I LOVE my Dr! Then she wrote a letter for me that explains that I was on a 1200 cal/day diet with excercise. It also states that I have daily food journals & exercise logs and I came in every month for a progress check. I was able to loose 10 lbs during that time. I also wrote a letter to send to them from my heart about how this will change my life & my family life; I inculded that my dad has HBP, Diabetes, High Cholesterol & had a stroke at 59, also that my mom has HBP, High Cholesterol etc.

I am really hopeful that between that, the proof that my BMI was over 40 (40.8 to be exact) when I started my MSLWP, and a description of the program my Dr had me on will be enough to get this thing moving!! Can you think of anything else I may need??

Also, why does the info always come in on Friday when they aren't open till Monday?? Patience!!! Thanks for reading this very long & rambling post )

Glenna

The explanations sound promising to me. I'll cross my fingers for you & hope you get approved soon. I know you are more than ready to be sleeved. Take care, Jan

[sweety93 18]

I'm waiting on the good news for you hoping all goes well

[gfawcetti 13]

Well, it finally got sent over today, so I will start calling tomorrow to check on it!! Thank you all for your support... it helps so much during this process!

Glenna

[Jacs 0]

Reading all this helps as I am in my 5 month with this. I also have bcbsil and I pray when the time comes I'll be approved This alone is long enough to do. Any info would help.

[RSREED53 4]

Just be proactive in every way with this. I took 4 years before getting OKd last spring for surgery May 31. It is worth it! Doing very well with my sleeve. xchange, congrats on getting your approval, and those waiting I will keep you in my thoughts and prayers that your day will come very soon. Hang tough! Ronda

[+change 5]

Glenna, Tomorrow, 10/12, is my day to be sleeved. I only spend one night in the hospital & when I get home Thursday, I hope when I check this blog that you have posted good news. Jan

[gfawcetti 13]

Thank Jan & I a sure you are recovering nicely from your surgery today! I called the insurance & they said they received my fax, however they haven't reviewed it yet... and that I should call back next Wednesday! Really, you think I am going to wait till Wednesday, I think not! I plan on calling daily LOLOLOLOL!

Hoping for great news soon!

Glenna

[+change 5]

Thank Jan & I a sure you are recovering nicely from your surgery today! I called the insurance & they said they received my fax, however they haven't reviewed it yet... and that I should call back next Wednesday! Really, you think I am going to wait till Wednesday, I think not! I plan on calling daily LOLOLOLOL!

Hoping for great news soon!

Glenna

Glenna, I'm home & sleeved. I already have favorite liquids & yogurt:)

Keep calling BCBSIL every day & get a rep that will contact medical review for you. You need to know if they have everything they need. I'll look for your approval soon. Hang in there.

Jan

[RSREED53 4]

xchange, I am glad you are home and doing well. Congrats on your sleeve surgery! Ronda

[sweety93 18]

Jan I'm happy to know you are home. Keep us posted. I'm wishing you a speedy recovery