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Approval Blue Cross Blue Shield of Illinois

I just wanted to come on and let everyone know that I received my approval today from Blue Cross Blue Shield of Illinois.... I want to post my situation, so that anyone pursuing this can see a positive outcome from BCBSIL.

I am doing to the Realize Gastric Banding Procedure. I have had a BMI around 40-48 over the last 5 years, have tried several diets over my lifetime. I don't really have any severe comorbities, except infertility issues and elevated blood pressure. I had about 12 months of documented Weight Watchers journals, but still had to do the 6 months of medically supervised diet/exercise. I started that process April 25, proceeded to go in May, June, July, Aug, and my final visit Sept 2nd. This was accepted as 6 months, although it was 6 visits, not 180 days. My Dr was great about making good notes in my chart, ie: vitals, weight, what I was doing, eating, exercising, what I should be doing, etc; and I went to the Dr specifically for this process. My information was submitted to BCBSIL in August to see if they would accept my Weight Watchers as part of my 6 months, and they replied that I needed one more month of notes, so that was completed Sept 2nd. That information was faxed on Friday, and I received my approval today, the following Wednesday. This process could not have gone smoother in my opinion. I think my very helpful Dr.'s office, Surgeon's office, and persistance were the key parts to this success.

I am having my surgery next Thursday, Sept 18th.

That is my story. Hopefully this can help someone going through the beginning stages of the whole process. Good luck to all of you.

Amy

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Your doctor hopefully weighed you at every visit and that is on your records also. That counts as records of obesity for 5 years.

Thanks, I will try to get my records from my old doctor. But I was just wondering do I need to have records of my weight for each year? Because I'm not sure I went to the doc each year in a row.

The want to see a 5 year history of obesity. If you were obese at the beginning of 5 years and you ended that way, chances are you were in the middle also. Hopefully they will see it that way too. Good luck.

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