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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?

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I just completed the 2nd half of my psych eval. Waiting on that appointment almost made me need psychiatric help lol. This was on Friday and the psychiatrist let me know it will take a couple of weeks to dictate so I'm hoping three weeks max for determination to be completed :). Im praying to hear Katrina Cmon down you are the next contestant up to defeat this stink monster of obesity! How Are things coming along at home?

Thanks for your good wishes regarding my surgery. I am doing much better at day 5 than I would ever have guessed. Can't wait to start eating scrambled eggs, tuna, tofu, etc! The sweet protein drinks seem much sweeter after surgery. I just tried my sample of Unjury chicken soup & ordered some. I got in 60 g of protein yesterday. I can't wait to hear good news from ya'll. Take care, Jan

Oh wait Ren your surgery date is upcoming this month?

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

You have surgery coming up Monday:) I wish you a successful operation, a speedy recovery, & a tool that fights obesity. Will look for your updates. Take care, Jan

Ok, so I don't know what to think... I called BCBSIL and was told that I needed more information from my Dr regarding the type of program that I was on for the 6 months of MSWLP. So my Dr wrote a letter explaining that I was on a low calorie diet with exercise 3 times a week, daily food journals & exercise notes; that i came in every month for a weight check etc... so I sent that over with the personal letter I wrote as to why I want the surgery. When I called yesterday they told me that they have my fax, but have not reviewed it & that my surgeon's insurance coordinator might get more information. So she did call in and magically between my call and hers they had reviewed the fax then sent it on for Dr. review & she should call back in a week for an update. My question, for all you out there, is: Is that a good sign?

I am optimistic that this is a step closer to surgery, like maybe before they denied it due to the lack of information and it never got to the Dr review part? What do you all think??? I have been doing this since Dec of last year & I just want the approval so the waiting is over...

Thanks for all your help!

Glenna

Yes. It's a good sign ;0)

But keep calling anyhow daily

Yes. It's a good sign ;0)

Really?!?!? I hope so!! I am really want this to be the next step for approval... Thank you for giving me hope!!!

I am optimistic that this is a step closer to surgery, like maybe before they denied it due to the lack of information and it never got to the Dr review part? What do you all think??? I have been doing this since Dec of last year & I just want the approval so the waiting is over...

Thanks for all your help!

Glenna

BCBSIL told me it could take up to a week for a decision but I kept calling. One rep got me so discouraged b/c she said I was denied while another rep went to bat for me & called medical review to find out exactly what the hold-up was. I know you are stressed but keep thinking positive thoughts. I am praying for you. I went through a similar experience with the same insurance & want you to finally get the approval for the surgery that will help you beat obesity. Did you ever try & reach Troy? Call them several times a day if it makes you feel better. I did a few times! Jan

BCBSIL told me it could take up to a week for a decision but I kept calling. One rep got me so discouraged b/c she said I was denied while another rep went to bat for me & called medical review to find out exactly what the hold-up was. I know you are stressed but keep thinking positive thoughts. I am praying for you. I went through a similar experience with the same insurance & want you to finally get the approval for the surgery that will help you beat obesity. Did you ever try & reach Troy? Call them several times a day if it makes you feel better. I did a few times! Jan

Jan,

Did they ever tell you that it was sent to a Dr to reviews? how are you doing, by the way?

Jan,

Did they ever tell you that it was sent to a Dr to reviews? how are you doing, by the way?

Several times they told me a Dr was reviewing my case. It is a good thing that a Dr is reviewing the documents but they still denied me 3x.

I am doing great. I had surgery on Wednesday, came home Thursday & was already walking with my husband at the park on Saturday. I was lucky not to have nausea or vomiting & had very little pain. Only took 1 of the 90 pain pills prescribed for me. I still sleep with a pillow over my abdomen but other than that you would never know I had surgery. The sleeve has definitely helped me eat slowly. I want you to be sleeved too & don't want BCBSIL to make you waste time. Keep hounding them. You have done what you were supposed to & know they need to cover the surgery.

Take care, Jan

Say your prayers. Yes, it seems like a very good sign. :rolleyes:Ronda

Ok, so I don't know what to think... I called BCBSIL and was told that I needed more information from my Dr regarding the type of program that I was on for the 6 months of MSWLP. So my Dr wrote a letter explaining that I was on a low calorie diet with exercise 3 times a week, daily food journals & exercise notes; that i came in every month for a weight check etc... so I sent that over with the personal letter I wrote as to why I want the surgery. When I called yesterday they told me that they have my fax, but have not reviewed it & that my surgeon's insurance coordinator might get more information. So she did call in and magically between my call and hers they had reviewed the fax then sent it on for Dr. review & she should call back in a week for an update. My question, for all you out there, is: Is that a good sign?

I am optimistic that this is a step closer to surgery, like maybe before they denied it due to the lack of information and it never got to the Dr review part? What do you all think??? I have been doing this since Dec of last year & I just want the approval so the waiting is over...

Thanks for all your help!

Glenna

Air high five.......Glenna we are awaiting the good news *fingers crossed* Jan you are doing awesome

Go Ren, sleeved on yesterday excited and waiting to hear that all went well

Air high five.......Glenna we are awaiting the good news *fingers crossed* Jan you are doing awesome

My good luck was due to all the good vibes from my sleeve friends:)

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