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I'm not complaining though...just under 7 months. They said 4-6.

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update: I have bcbs of Illinois ppo...They only require me to see a dietitian and psycho exam. I already seen the dietitian and see the psychologist Monday. After that is done it will be submitted for approval. My first visit with the Dr. was Jan. 30th. That was to just talk to the doctor and to make sure i was within the bmi range for the surgery..then we discussed the best surgery for me. It's going pretty fast :). Keeping fingers crossed i get approved. The nurse said surgery could be late March early April :)

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I have BCBS as well. My claim was submitted on 11-30-12 as well. I still have not heard back from them . Praying I get approved soon.

I had my surgery on Jan 30th. So it was 4 months from first appt to surgery date. I am happy with my results . :)

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I have BCBS IL and I was approved the same day they received the paperwork from my surgeon's office. I had to call a LOT because the office kept saying they sent it, but BCBS kept saying they hadn't received it. I kept calling until they said they had it and she said she would try and get my paperwork through medical review quickly. I called back the next day and was approved!

Before submitting to insurance I had completed all the normal things - psych eval, bloodwork, medical clearance, nutrition class. I also had to do a colonoscopy and endoscopy, but that was because I had a band that was causing me issues and they wanted to be sure they could do everything in one surgery.

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So sad...bcbs of Illinois denied me. Surgeons office is going to resubmit it with more information showing my medical conditions. Apparently being on medication for high blood pressure and high cholesterol is not enough :/...They want to see numbers showing that it is not controlled with meds. This may just be the end of my journey :(

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So sad...bcbs of Illinois denied me. Surgeons office is going to resubmit it with more information showing my medical conditions. Apparently being on medication for high blood pressure and high cholesterol is not enough :/...They want to see numbers showing that it is not controlled with meds. This may just be the end of my journey :(

Don't give up yet...some people take longer to get approved than others.

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I'm trying to stay positive...I was so sure i would be approved so this was a real let down.

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Hello everyone,

I just found out that my revision from band to RNY was denied because it "was not medically necessary." I was so shoked BCBSIL did this.

After we got the denial, my surgeon had a peer to peer phone call with them. I am awaiting the results.

Has anyone had a denial for band to RNY revision? Was anyone able to get the decision overturned? I am desperate!

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Hello any help would be great as my date is set for July 23rd. I have blue shield and they denied me because they said I was missing a paper. We re faxed it in and they said they can take an additional 5 days. Has anyone heard of this? Has anyone had this happen to them? Will it take the full 5 days at that point? Some say it's quicker but I'm worried.

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I got got my approval yesterday 7/21/14!!! I am so happy!!! My surgeon was able to do a peer to peer call with BCBSIL and it worked. Thank God!!!!!!

Hello everyone,

I just found out that my revision from band to RNY was denied because it "was not medically necessary." I was so shoked BCBSIL did this.

After we got the denial, my surgeon had a peer to peer phone call with them. I am awaiting the results.

Has anyone had a denial for band to RNY revision? Was anyone able to get the decision overturned? I am desperate!

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Hello! I have BCBSIL and got denied for band to RNY revision. They came back with that denial after about 5 business days. My surgeon scheduled a peer to peer meeting with them and after another 10 working days I was approved. You MUST have a surgeon who is ready to get on the phones and fight.

My surgery date is Monday 8/11! Best of luck to you - do not lose hope.

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wow, I thought i had it tough with my insurance

3 groups

2 Dr. visits with the doctor who did labs

2 phyc visits

5 appts. w/nut

2 actual visits with the surgeon

sleep study

I think that was everything lol

All in all it took 9 months. They sent it to my insurance company in march 2013. I got approved on 4/19/13 but it took until 6/25/13 to have the surgery cause my surgeon wa booking 6-8 weeks out.

From going to the support groups I found out that this was quick.

I have BMC BOSTON HEALNET w/MASSHEALTH as secondary. I am just so gratefull i have the coverage. I hear all the horra story's. My heart breaks for the girl who was billed years later and had to declare bankruptcy.

I was able to get a Tummy Tuck 5 weeks ago cause of all the skin and rashes. I was denied 3 times. I had to changed the plastic surgeon and when I did I was approved in 7 weeks and my surgery was scheduled 2 weeks later.

i had sleep apnea, as well.

I really hope everone who needs this surgery gets it. It is a tough decision to make to even go for the surgery.

KEEP FIGHTING!!!!!!!!!!!!!

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Hi I too have BCBS IL with no supervised weight loss requirements. I have been thru a few appts already, met the MD, met with the surgeon, and had my Psych Eval. I have my NUT appt Weds, but am starting to get nervous about approvals after reading some horror stories. I have a BMI of a 36.2, with high blood pressure. I am on protonix for heartburn and they spoke of scoping me. If the requirements from the insurance company state BMI 35 with 1 comorbidity and med records should I worry about denial?

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