Guest guest Posted October 6, 2000 Report Share Posted October 6, 2000 Jon, I too have BCBS of AL and had a little trouble getting approval, but in the end they approved me. I was nearly 100 lbs over my " ideal " body weight (if you went by Ins charts) but the most important should be the co-morbidities. Do you have them? If you wrote an appeal letter mentioning your co-morb. and had your primary care physician do the same, it might sway them. Especially since the doctor in charge of medical review ( he actually makes the decision) is a doctor from Birmingham or maybe Tuscaloosa. I have his name somewhere here in my notes. Hold on! Yes, Dr. Hansford. He can be reached at fax # . I believe he used to be a pediatrician in Opp, AL, many years ago. His address is, of course, BCBS of AL, P. O. Box 995, Birmingham, AL 35298. If you would like I can e-mail you a copy of the letter I faxed to him that seems to get me over the hump. Just send me your e-mail address. Dinah Andalusia, AL I'm sorry, I have to say this! WAR EAGLE! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2000 Report Share Posted October 8, 2000 Thanks very much! I'll give him a whirl! Roll Tide! Jon in Tuscaloosa 5'6 " , 270, BMI 43 Doin' the dance on 11/22 > Jon, I too have BCBS of AL and had a little trouble getting > approval, but in the end they approved me. I was nearly 100 lbs over > my " ideal " body weight (if you went by Ins charts) but the most > important should be the co-morbidities. Do you have them? If you > wrote an appeal letter mentioning your co-morb. and had your primary > care physician do the same, it might sway them. > > Especially since the doctor in charge of medical review ( he actually > makes the decision) is a doctor from Birmingham or maybe Tuscaloosa. > I have his name somewhere here in my notes. Hold on! > > Yes, Dr. Hansford. He can be reached at fax # . I believe > he used to be a pediatrician in Opp, AL, many years ago. His address > is, of course, BCBS of AL, P. O. Box 995, Birmingham, AL 35298. If > you would like I can e-mail you a copy of the letter I faxed to him > that seems to get me over the hump. Just send me your e-mail address. > > Dinah > Andalusia, AL > > I'm sorry, I have to say this! > > WAR EAGLE! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2000 Report Share Posted October 9, 2000 I was told that unless you have been previously declined you can't send it to him first. I know that there are two main things they are looking for: twice ideal weight for more than 2 years and medically supervised attempts along with numerous other attempts at weight loss. Hope this helps anyone in the probess of trying for approval with BC/BS of AL. Kristi at the beach And RRROOOOOOOOLLLLLLL TTTTIIIIIDDDDDDEEEEEEEEEEEE ROLL! hehe > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2000 Report Share Posted October 9, 2000 Dear Beach Lady: I have been denied on the grounds that I'm not 2X ideal weight, much less at that weight for 2 yrs. I think this is unreasonable, as it's far beyond NIH standards (>40 BMI and/or 100 lbs. above ideal weight), and would make for a good lawsuit but, as previously posted, I simply don't have the time to pursue it. But thanks for the suggestion anyway! Best, Jon in T-town 5'6 " , 270, BMI 43 Dancing on 11/22 > I was told that unless you have been previously declined you can't send > it to him first. I know that there are two main things they are looking > for: twice ideal weight for more than 2 years and medically supervised > attempts along with numerous other attempts at weight loss. > Hope this helps anyone in the probess of trying for approval with BC/BS > of AL. > Kristi at the beach > > And RRROOOOOOOOLLLLLLL TTTTIIIIIDDDDDDEEEEEEEEEEEE ROLL! hehe > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 5, 2000 Report Share Posted November 5, 2000 Rah, rah, rah! Go team! > > In a message dated 11/5/00 7:00:25 PM Eastern Standard Time, jsb@... > writes: > > << We're all rooting for you! Just relax and let the good vibes wash over > you, and don't hesitate to ask if there's >> > Thanks so much, Jon. It really means alot that you all are thinking of me. > > Ruqayya > > Quote Link to comment Share on other sites More sharing options...
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