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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!

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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!

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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

>

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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

>

> >

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  • 4 weeks later...

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

>

>

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