Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

BCBS IL DENIED TOO MANY STRESSORS [emoji20]

dcole007

By dcole007, in Insurance & Financing

Recommended Posts

dcole007    21

dcole007
Posted

I am soooo upset. BCBS of IL denied me because of my therapist report. They said I have too many stressors. My therapist put some inaccurate information. His wording was all wrong. I have a copy of the report and I am not happy. Has anyone ever dealt with this and anyone have information in how or what I can do about appealing this? I'm not sure if I should just get a new psychological evaluation or if that would even work. I've been seeing my therapist and I feel like he is biased and I just should not have had him do it in the first place.

Best wishes!

Dotty Cole

Share this post

Link to post
Share on other sites

Lannie    135

Lannie
Posted

Can your Bariatric center advise? Have you asked the insurance if you can resubmit with a new eval?

Good luck

dcole007 reacted to this

Share this post

Link to post
Share on other sites

dcole007    21

dcole007
Posted

Can your Bariatric center advise? Have you asked the insurance if you can resubmit with a new eval?
Good luck

So after talking to my therapist, doctors office and insurance company the first thing is my therapist that did my evaluation is going to do a peer to peer and explain how he miscommunicated information. Tomorrow I am scheduling a new psych evaluation with a non biased doc that specializes in bariatric psych evaluations and my docs office will use it to appeal. My therapist just did terrible. He was very apologetic today and ever and told me he was so sorry for the miscommunication. So I am sensing no him an email in the morning so he can fix this. I only get 2 appeals so the peer to peer doesn't count as one. I was trying to get everything done quickly to get it submitted to insurance and my gut told me to just go to the psychologist my doctors office recommended. When will I start listening to my gut!!! Uughh


Best wishes!

Dotty Cole

stibitzal reacted to this

Share this post

Link to post
Share on other sites

TCurry    1

TCurry
Posted

My husband works for AT&T we have BCBSIL as well and I am about to start the process to try and have my weight loss surgery covered. I hope your appeal goes well. I am praying praying they cover mine. It's my last option I have tried everything else under the sun.


dcole007 reacted to this

Share this post

Link to post
Share on other sites

dcole007    21

dcole007
Posted

My husband works for AT&T we have BCBSIL as well and I am about to start the process to try and have my weight loss surgery covered. I hope your appeal goes well. I am praying praying they cover mine. It's my last option I have tried everything else under the sun.




It really is an easy process with an easy approval if you meet the requirements, 40 BMI or above, any chronic conditions, and a psych evaluation. They have you do the preop blood work and ekg, and then submit. When I went for my initial visit I saw the nutritionist and that was the only time I had to see her. If my therapist wouldn't have did the crazy job on the letter I would already have a surgery date. Just irritated because I already met my out of pocket so everything would be at 100% if I have it this year. But it's probably not going to be until next year at this rate.


Best wishes!

Dotty Cole

Share this post

Link to post
Share on other sites

TCurry    1

TCurry
Posted


It really is an easy process with an easy approval if you meet the requirements, 40 BMI or above, any chronic conditions, and a psych evaluation. They have you do the preop blood work and ekg, and then submit. When I went for my initial visit I saw the nutritionist and that was the only time I had to see her. If my therapist wouldn't have did the crazy job on the letter I would already have a surgery date. Just irritated because I already met my out of pocket so everything would be at 100% if I have it this year. But it's probably not going to be until next year at this rate.


Best wishes!

Dotty Cole




Thanks. I was hoping to have it by end of year as well since we had met deductible but looking like if approved will be in early 2018. I go for consult on Wednesday. Keep me updated how yours goes. My surgeons office hasn't dealt to much with
our insurance before. Did you have to find your own psychiatrist to do evaluation?



Share this post

Link to post
Share on other sites

TCurry    1

TCurry
Posted

Hey checking in to see how your process is going? I just got my approval today! Hope all is going good with insurance! Best of wishes


Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Go To Topic Listing Insurance & Financing

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×