Skip to content
View in the app

A better way to browse. Learn more.

BariatricPal

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
  • Appearance

Join BariatricPal free

  • Ask your own questions
  • Reply and follow topics
  • Message other members
  • No cost, no spam

Denied AGAIN with BCBSIL

I am just devastated for the 2nd time! The insurance wants MORE information from my 6 month visits. They said the doctor was not descriptive enough. They want diet and exercise progress. I know what I discussed with my doctor in each visit but I can't control what she types in her records. I'm so frustrated now. I've been denied twice over this. I'll appeal but I'm scared this is going to go no where. My biggest fear is that I will have to find a whole new doctor and do another 6 months all over again. I've been on this for 9 months now. I just dont know what to do. ... Maybe curl in a ball in the room and cry?

Advise?

  • Replies 90
  • Views 9.5k
  • Created
  • Last Reply

Top Posters In This Topic

Featured Replies

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..

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

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 :)

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

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 :)

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

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

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,

:)s thank you bunches

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

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!!!!!

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

Jan

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...

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

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

Join the conversation

You can post as a guest; create a free account to track replies, follow topics, and be part of the largest weight loss surgery community.

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

Account

Navigation

Search

Search

Configure browser push notifications

Chrome (Android)
  1. Tap the lock icon next to the address bar.
  2. Tap Permissions → Notifications.
  3. Adjust your preference.
Chrome (Desktop)
  1. Click the padlock icon in the address bar.
  2. Select Site settings.
  3. Find Notifications and adjust your preference.