CRITERIA: BLUE CROSS/BLUE SHIELD of ALABAMA

[Guest guest]

I became privy to the " Secret requirements " to get approved the first time.

Here it is for all state of ALABAMA residents:

There are basically two BC/BS of Al. policies

1. State employees - who have a pre-cert co. called Cost Care. Pretesting is

all that is required. (e.g.)Psychiatric eval, sleep study, etc.

2. Non-State employees and non-Cost Care: They have fairly recently made it

more difficult to be approved, but if you meet their criteria they will

approve. This criteria is as follows:

A. (Detailed) Diet history for at least two years.

B. Obtain documented body weight history for the past two years

This should come from your Primary Doc.

C. Documented two year history of weight loss attempts through Dr.

Supervision. This documentation can be as old as five years ago.

Here are a few Unwritten rules:

1. Have a letter of medical necessity from at least your PCP.

2. Written letter from the insured on how obesity affects them.

3. They may say you have to get the physical from the surgeon to discourage

you.

Send them all of this the first time you file and VOILA...you get approved.

Email me if any of this unclear.

le/May 29, 2000

Blue Cross Blue Shield of AL

Approved first time after a waiting period.