MaddMama

That's REALLY great! So happy for you! Let us know how everything goes from here!!

So my surgeon;s office called Blue Shield to get started on the pre-approval process for a surgery date and they told her my Surgeon wasn't covered as she wasn't in the "designated county." (If you live in certain counties, you have to go to very specific surgeons here in Ca. with BS.) HOWEVER, I had done all my homework ahead of time and was already told I was not in that category. LUCKILY, I do all my correspondance with the issurance company vie Email so I have documentation of that conversation.. so they had to admit their mistake (mistake #1.) THEN, we get that clarified and taken care of just in time for them to tell the surgeon that I AM able to go to her BUT because she is an out-of-network provider, the cost will be significantlly more. That would be understandable usually EXCEPT that the Blue Shield Advisor is the one who gave me THAT surgeon's name and contact information when I called to "Find a provider!" (mistake #2) Ridiculous..seriously!! I even logged into my account, looked up the doctor, and PRINTED the page that SHOWED she was on the approved in-service provider list on their website. WOW! All this and I have haven't even STARTED the fight for the actual approval yet. I forsee a loooooonnnngggggg road ahead of me =) LOL

Thanks for the updates. It's great to have informed consumers and fellow Sleevers to help guide along the process. That's awesome how well you are doing!! That must feel fantastick! I can't wait. I am sure to update as I move along this process. Any other advice or just insights are GREAT! Thanks a million.

Did you ever hear back from the "peer to peer?" I gave the exact same med. issues, but we haven't submitted for approval yet. I have Blue Shield Ca. and I don't want to start the sleep study and GI process if I know I will just be denied.

That's great. Did they say how much your out of pocket expenses would be? I am just now starting the process, and I am still confused over what is and what is not included and covered. I have Blue Shield Ca. also. Which surgeon are you going with?