So frustrated! Updated requirements w/BCBS of NC.....

[musiclady2014 16]

In October when I met with my surgeon and began compiling the requirements for surgery, BCBS of NC did not require the 6 month weight loss history with a PCP. However, last Friday we FINALLY submitted the fulfilled requirements to insurance and on Tuesday we found out that I was not approved on the basis that I had not completed the requirements for full review.... And the requirement that I was missing was the 6 month weight loss record with my PCP. I also found out that the new requirement was effective IN OCTOBER... Which means it was updated shortly after my surgery center requested the requirements. I am so angry because had I known about the 6 month requirement, I would only be one month out from surgery... Now I am six! I have been overweight my while life and I am at my limit dealing with my weight... I just can't do it anymore!

Has anyone experienced a change in requirements in the middle of compiling a previous set of requirements? If so, how did you deal with it? Any luck battling the insurance company for approval anyways?

I feel like such a Bitter Betsy right now and can't stand the thought of six more months!

[Strangefruit 179]

I don't know what to tell you, except it sounds like at least your insurer WILL cover you... lots of folks have to self pay or go to Mexico. My insurer made me wait a year - a full YEAR - from request to surgery, and even though I thought I would never get there, I finally did. Have you read: "The Emotional First+Aid Kit" A practical guide to life after bariatric surgery? It's by Cynthia L Alexander, PsyD, and I didn't read it until AFTER my surgery, but I wish I had read it before. I recommend it highly... Good luck on your journey!

[KristinaRnY 455]

That is really a bummer, my insurance requires a year and after that it's still months before you have surgery.. My date is April 9th and I have been in the program since December 24, 2012! At first I was really frustrated but am now grateful because it has given me the opportunity to make lifestyle changes and to lose some weight on my own. By doing this I hope it makes the transition to post op life easier and they have really educated us on how to use our tool and have life long success with it. Be patient, everything happens for a reason and your time will come exactly when it is meant to I know that doesn't ease your frustration on the situation but try to stay positive. It seems like you should be "grandfathered" in on the old requirements since you started before the change was in affect... If that's not the case that is really shitty. They should have notified you.

Edited February 20, 2014 by KristinaRnY