Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Denied AGAIN with BCBSIL



Recommended Posts

Eyes, toes, and fingers.....I'm so hoping for an approval for you :)

Share this post


Link to post
Share on other sites

ugh my insurance did not meet the deadline by 5 on Friday so I have to wait till Monday to find out if I'm approved or denied trying to be patient..

Share this post


Link to post
Share on other sites

I know its annoying, but we are expecting good news ;) so we will just save our hoorays for Monday :)

Share this post


Link to post
Share on other sites

yessss its very annoying ugh but thanx so much I'm praying a celebration is in order<3

I know its annoying, but we are expecting good news ;) so we will just save our hoorays for Monday :)

Share this post


Link to post
Share on other sites

Me to.....Virtual High Five....I'm still working on approval and until then I'm going to keep cheering for everyone :)

Share this post


Link to post
Share on other sites

yesss virtual high five indeed lol...guesssss what just found out today im approved!!! my authorization code is 00214593 waiting for patient navigator to call me about my final pre op appointment && then I'll get my date im so excited no longer nervous goodluck to you I'll be praying you get approved as well keep me updated && goodluck<3

Me to.....Virtual High Five....I'm still working on approval and until then I'm going to keep cheering for everyone :)

Share this post


Link to post
Share on other sites

Congrats on getting approved!!!! 3 more months for me... You're on your way!!!!!

Share this post


Link to post
Share on other sites

Jan, come and join us on the October 2011 board!! We'd love to have you!!

Keep calling BCBSIL every day & get a customer service rep that you like to call medical review for you. I was denied 3x & finally today I got my approval. It is such a good feeling & can't wait for my surgery 10-12. What a relief. Jan

Share this post


Link to post
Share on other sites

i called today & they did not show the fax from Friday in the system!! UGGGGHHH!! I am trying to be patient, but I am not very good at it LOL... I just want the approval so I can plan my holidays, time off etc. Congrats on your approval!! Do you mind me asking your stats, why did they deny you & what did you do to get them to change their mind?? Sorry it that is too personal I just need some pointers,

Share this post


Link to post
Share on other sites

:)s thank you bunches

Share this post


Link to post
Share on other sites

The 1st time I was denied in May b/c I hadn't completed a 6 mos nutritional program. The 2nd time they denied me early September they said I didn't have a 2nd co-morbidity since my bmi is 38 & I hadn't completed the nutritional program. I had completed a 6 mos class at the hospital in which I was weighed monthly, b/p recorded, exercise & challenges for the month discussed. I do have 2 co-morbidities which are dyslipidemia & sleep apnea. I had to have my doctor resend the documentation of my visits (dates highlighted) + additional information about the program & information from my sleep study. The 3rd time they said I wasn't treating my dyslipidemia in the past 6 months. I was scared b/c I do not take statins but my doctor sent them a document stating I take fish oil for high cholesterol. I called BCBS & was so frustrated b/c I wanted to know exactly what else they needed. I was very lucky I got a customer service rep who listened to me & made a call to medical review & he called the next day to say I was approved. I think BCBSIL wants to deny several times. I felt like I was holding my breath for weeks. I am so ready for my sleeve as I know you are. I wish you the best & hope you are approved soon.

Jan

Share this post


Link to post
Share on other sites

Awwww thank you so much those 3 months will fly by in no time!<3

my patient navigator called me bright && early guys my surgery date is the 17th at first she said she only had the 24th but called back a few minutes later with thee earlier date awww im so excited I know its hard & tiring being patient but with time & fully committing effort to do whatever to get approved you will keep fighting guys<3

Congrats on getting approved!!!! 3 more months for me... You're on your way!!!!!

Share this post


Link to post
Share on other sites

The 17th is 5 days after my surgery. Join the October 2011 sleevers & we'll stay in touch. Congrats!!!!!

Jan

Share this post


Link to post
Share on other sites

Well, I spent 30 min on the phone with BCBSIL & am a bit frustrated LOL.... They still do not have the paper from Friday that states my BMI for April, and now they are saying that my Dr. notes are not detailed enough! Seriously!??!?!? Its like they enjoy making us dance through this pre-requirements for fun! I am just going to schedule an appt with my Dr so that we can sit down & update the notes, I figure if I am right there then it will be done faster LOL and patience is not something I have an abundance of right now.

Thanks for all your support...

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 1 reply
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • 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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×