State by State Lap-Band Surgery appeal rights link

I have an opportunity to elect Blue Cross Blue Shield of Illinois and I'm wondering if anyone has any experience with them. I'm in the early stages of considering Lap Banding...

Does anyone know a way around the DR documented weight loss attemps of 6 or months? I have been on Jenny C, WW, Atkins, Phen-Fen, Cabbage soup diet, you name it I have tried it, but never with a Dr's help. I currently have hypertension that is being treated w/ meds, GERD, and a BMI of 36.7. I contacted my insurance (BCBS) and I meet all criteria w/ the exception of the Dr documented weight loss attemps. I feel so frustrated.

donnajorn

I have an opportunity to elect Blue Cross Blue Shield of Illinois and I'm wondering if anyone has any experience with them. I'm in the early stages of considering Lap Banding.

Hey donnajorn,
I don't know if you have already had your questions answered. I have Blue Cross Blue Shield of Missouri and they did say they would pay for my surgery. However now that I have had surgery they are saying it's over the maximum allowed and are refusing to pay. The Weight Loss Center stated that they will fight with them and I hope that is true and I hope they WIN! I can not afford to pay the charges they have sent to the insurance company it's a bill of like 56,000.00 if I had that kind of money laying around I wouldn't have too many worries. Anyway just be careful if you get them as insurance and they say they will cover your surgery. You may be fighting with them later.
Thanks,
Amy :)

I , also can not find the STATE BY STATE link in this Obesity law section. but, a lot of good information.

<p>Obesity Law and Advocacy Center</p>

Hi, I took all my receipts to my PCP, who I see at least every 3 months anyhow. He was satisfied with that and signed the form.
Good Luck to you

Check out UT Medical Center in Knoxvile Tn
Address 1924 Alcoa Hwy 37921
Phone: 865-544-800

I know what you mean about being frustrated. I also have BCBS. At first my Doctor wouldn't do anything with the paperwork so I made a appointment with him and asked why he wasn't be supportive. He filled in the date, weight and BP as well as all my DX and I'm to fill in the rest and after he looks at it and signs it I can then send it to BCBS. With all the waiting I told my doctor to go ahead and send the other paperwork ( which is a complete copy of all my office visits with my PCP )in to see it they would approve it without the 6 month doc.

BCBS of IL will pay when pressed They want you to feel defeated ashamed and embarrassed DONT

I have the same problem, have you found any way of getting around the 6 month???

I took all of my credit card statements and receipts from weight watchers Jenny craig, nutrisystem, curves and listed all the over the counter stuff I took for weight loss. He was glad to see my proof and waivered the 6 month issue.

But even if you go to him/her first, by the time you see the lap band doctor and have all the tests it will at least be 8 weeks and with your proof of diets, your PCP will know you mean business and sign the form.

Good Luck

I got my reply by phone today I was denied due to my BMI. 1 point or (3 pounds) can you believe it I have High BP High CHOl./Trig and strong family history heart disease. I'm so down

This link isn't working for me. Has the web address changed or something?

Thanks!
Ryan:help:

I can't get it to work either

I also have Medicare as my primary hospital insurance. I will have my surgery at Grinnell, Hospital in Grinnell, Iowa. You might try contacting Medicare or going to their sight on the web and do a search. Previous to finding out about this hospital - my only choice in Iowa was to go to Chicago!!! Good Luck