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Bcbs Alabama So Irratated!

I still have not heard back from case manager.. I call every day and my paperwork has been there over two weeks... I spoke to case manager Monday and she said she would be looking at my case that day or next day... Called back yesterday to check again.... And cust service said oh it's been changed to In process... Big deal... I'm trying to stay posit ie but getting harder and harder... My partner is having baby at end of year so I was hoping to have surgery before that happens. The only thing the lady said was well its just a busy time of year ...

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**positive**

PS I asked if there was anything else she needed as I have sent all that was required and more! 3 year history of obesity 40+, current BMI 41, proof of 7 month HCG diet supervised by doctor...chart notes and receipts of weights bmi once a month,, psych clearance, PCP clearance and recommendation, NUT clearance and notes on family history, diet history failures, surgeon request and paperwork, sleep apnea test done and I have mild sleep apnea, all bloodwork done...but pre diabetic.....I just don't get why it take so long....;(

I am going through the same thing waiting is so hard to do ...

  • Author

Super hard! I called again today and actually spoke to my case manager... Surprised she answered...and she said oh you only had one dr appt in 2009 reported so I had to get a note stating I only went to the dr that one time.... Kinda tedious if you ask me. But had them fax that right away and asked her if I would be delaying by two weeks again grrrrr. She said no she would watch for it... Then she said she just needs to review my diet info but ill keep you posted...fingers crossed...

  • Author

Super hard! I called again today and actually spoke to my case manager... Surprised she answered...and she said oh you only had one dr appt in 2009 reported so I had to get a note stating I only went to the dr that one time.... Kinda tedious if you ask me. But had them fax that right away and asked her if I would be delaying by two weeks again grrrrr. She said no she would watch for it... Then she said she just needs to review my diet info but ill keep you posted...fingers crossed...

  • Author

Super hard! I called again today and actually spoke to my case manager... Surprised she answered...and she said oh you only had one dr appt in 2009 reported so I had to get a note stating I only went to the dr that one time.... Kinda tedious if you ask me. But had them fax that right away and asked her if I would be delaying by two weeks again grrrrr. She said no she would watch for it... Then she said she just needs to review my diet info but ill keep you posted...fingers crossed...

  • 5 months later...

So...its been a while, did you get approved?

My surgeons coordinator told me that she submitted mine and Bcbs of al said that they needs more information. I called Bcbs today and they told me that I didn't meet the requirements. Then the ins lady told me that I was denied electronically when the author coor. Sent it. So I am confused about whether I have been definitively denied or if they are reviewing. Is this the way you were handled?

My surgeons coordinator told me that she submitted mine and Bcbs of al said that they needs more information. I called Bcbs today and they told me that I didn't meet the requirements. Then the ins lady told me that I was denied electronically when the author coor. Sent it. So I am confused about whether I have been definitively denied or if they are reviewing. Is this the way you were handled?

I haven't finished my 6 month diet yet, so I can't submit until that is done. I've heard though, that you can appeal. Just find out first why you were denied. You can even have your surgeon ask for a peer to peer evaluation, which would probably help.

I called BCBS earlier today. The Customer service lady was denied first for her sleeve. The dr has to send paper work so they review it and then decide.

Let us know what happens!

Wow, that was quick! Congratulations! You are going to lose so much weight by the time I get to have my sleeve (Hopefully in December)!

Congratulations! Good luck. It is not far off ;)

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