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- GLP-1 medication Zepbound, Wegovy, access, side effects, progress, and support.
- Before surgery Compare procedures, plan ahead, and get honest pre-op answers.
- Post-op Recovery, food stages, symptoms, and support.
- Long-term Regain, labs, habits, and life after the honeymoon.
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Everything posted by Tory09
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Medical Review Process
My surgeons office sent in my paperwork last Friday. It has been a week and when I call the insurance company they have nothing in the computer as of yet. They said this doesnt mean they didnt get the information, it is probably over at medical review which they are the ones that review it then decide on approval or denial... Was this the same for you all when you called the insurance company while they were reviewing it? That they didnt have a record but it was probably at medical review? I have Anthem BCBS PPO... I am just worried...I need all the prayers I can get... Thanks!:thumbup:
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Curiosity killed the cat.....
My drs office sent in the paperwork last Friday. It has been a week and when I call the insurance company they have nothing in the computer as of yet. They said this doesnt mean they didnt get the information, it is probably over at medical review which they are the ones that review it then decide on approval or denial... Was this the same for you all when you called the insurance company while they were reviewing it? I am just worried...
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Are we in for a change
I totally agree with you... I think that what you said it is EXACTLY what is going to happen... I am waiting for my insurance approval as we speak :thumbup:
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Had all testing done. When do they call you for next appointment to set surgery date?
I am in the same boat... no one has called me so far... My surgeon has never called me in to go over any of my results... I did call the office a couple of times last week and they said they are trying to get everything ready and dictated from each appt and written up to submit the package to the insurance company. It is so hard to not worry during all of this!! Good luck to each of you!
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How long did your process take to get approval?
Hey Froggy, No I talked with the surgeons office 3x last week. The insurance lady told me the nutritionist and psych evals have been dictated but that she still doesnt have my file. The lady left me a msg saying I had 2 other things that the dr wanted... I left her back a message and told her the dates when I already had the appointments. It is just very slow. So no my stuff is still getting dictated and recorded in my file for them to send to the insurance company. I am trying my best not to worry and not to get too impatient... I still need your prayers!!!!!!!! Thanks, keep me posted and I will too :sad:!!!!!!!!!
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So... got some work to do.
Jason, You are doing so well on your weightloss! What are you doing to lose that amount of weight in such a short amount of time. I am so happy for you!!!!!!!!!!!
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BCBS Anyone? Share your experiences
Hello everyone, Care to share your experience with BCBS... I have Anthem BCBS PPO of Virginia... I am still waiting on my surgeons office to send in all the paperwork for approval. Once your office sent it in, how long did it take for you to get approved or denied? I am so anxious, just keeping busy at work... but it is hard not to worry about the approval process. I have started calling the surgeons office once a day, but so far they keep saying my file is in a different dept. I guess they are trying to get all the different appts I had together in one place. However, I dont know ... they just say they dont have my file and this person may have it etc... So I am just calling once a day....So frustrating... Good luck to everyone !
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BMI 39-bcbs of north carolina
That is so great to hear!!!!!!! I am so happy for you... I am still waiting on my drs office.. They said my file is still floating around... I have called 2 days in a row. Guess I will just call everyday to remind the lady I am waiting to hear when she sends my info to the insurance company. Please pray for me... Thanks so much.
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Feeling Discouraged and down...
LastChance, Thanks everyone for their comments... You are right lastchance, I called the drs office again today and the insurance lady said she didnt have file still. She was going to go find it... she thinks it may be with the sleep study people... why would they take my entire file? Weird but I guess they could still have it. I dont hear about my sleep study till next week so hopefully they have sent my chart back to the surgeons office. You are so right, it makes more sense to make sure everything is in order before its sent to the insurance company. Keep in touch and let me know how you are progressing...! Good luck to everyone... i still need your prayers THanks...
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September 2009 Band Date
You all are so fortunate to have surgery dates in September. I just heard from an acquaintance that her surgery is set for the 3rd week in September and she got approved thru insurance. We have the same practice. I was so hoping for a sept date, not an Oct date. Well i called the insurance person today and asked about when my completed package would be sent into insurance. She did not have my file on her desk and had to find it. Then she never called me back... this is so frustrating. Should I call her back tomorrow or wait another day???
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Feeling Discouraged and down...
Thanks guys, I called my surgeons office today and asked them how long it will take for them to send my complete package into insurance... the insurance lady said well I dont have your file on my desk so let me find it... and I will call you back. She never called back ... guess I will call her tomorrow... Such a lengthy process ....
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Breaking the Diet Coke cycle...
I can tell you that no one was a bigger diet coke drinker than myself. I would drink probably 1 1/2 2-liters a day... I quit a few weeks ago cold turkey. I started drinking cold iced tea since it has been so hot outside... I also started adding a little sugarfree sweetner to it to just give me a sweet taste. Good luck to you!
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How long did your process take to get approval?
You are super lucky and very fortunate. I wonder why my dr office doesnt submit for approval before hand? I guess they want to know if you have any comorbidities before submitting to insurance... since that would make it easier to get approval... Good luck to yoU!
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Sleep Apnea test?
I had to do the test while laying on my back the entire night. At midnight they came in and put the cpap machine on me and told me not to move. It was horrible. Took almost 2 hrs to fall asleep with the cpap on me... Also, they took one pillow away from me so i was basically straight on the bed. In the morning, the tech said i did so much better with the sleep machine on me. He told me I did not have sleep apnea, just shallow breathing. I read online about this and this is usually only if you sleep on your back. I am a stomach and side sleeper so there statistics will not be valid since they forced me to only sleep on my back. I personally think this is a scam to make more money for all those involved especially the sleep center, vendors for the machines etc. It was the WORST appointment I had ever had. I will do what I have to do to get thru all of this but that appt was horrendous!!!!!! I hope I do not need a CPAP machine because it is claustrophic and I will never use it.
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Sleep Apnea test?
EmmyLou, I had to have the stupid sleep test too even though I told them I didnt have it. It was a HORRIBLE night and I see why people leave. I found out I also have Hypopnea thats what the technician said. I left the sleep center a message and they are going to call me tomorrow. I hope I dont have to rent a cpap machine. Did they tell you that? They put the cpap machine on me and I was able to sleep for about 4 hrs but it was HORRIBLE. I felt claustrophobic and I would NEVER use that in real life. I am just jumping thru these hoops to get approved. I see you live in Va as well. Did anyone say this is a comorbidity and do you have to use a CPAP machine? Good luck to you!
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Feeling Discouraged and down...
Thanks guys, I appreciate the support. I am going to go to a support group meeting tomorrow night as well. I have really good health insurance Anthem BCBS PPO of Va so I am hoping I will be approved. My husband doesnt communicate much but he said if it is what I want then he is all for it. I have two small kids and i want to be around for them for a long time and the rate I am going I wont be. My family all has severe diabetes and I am trying to take this as as preventative measure. I just hope and pray that I get approved and my surgery is successful without complications... Thanks for listening...
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Feeling Discouraged and down...
:cool: Hi everyone, Just wanted to vent a bit. I thought my family was behind me in my lapband decision but now they are saying things like you can lose weight on your own, etc. I am just feeling down and scared about the approval process. I am right on the border 39.9/40 bmi so I am afraid of not getting approved. I am not sure if I have any comorbidities cause no one told me my test results from my blood workup - i.e. high cholesterol, high liver enzymes, etc... Please pray that I get approved. I am so wanting to start this phase in my life. Thanks for reading.
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How long did your process take to get approval?
Froggie, I understand how frustrating it can be! I saw the surgeon first and then did all of my appts. He wanted me to get blood work done too and also a sleep apnea test. I never heard back from anyone on either thing. I wish they wouldnt make you go thru so many hoops. That sleep test was HORRIBLE and the technician said i dont have sleep apnea. I hate this waiting game. It is hard to not worry about everything... I am just doing my best to wait things out and pray about it.... Keep me posted! Good luck !!!!!!!!!!!
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How long did your process take to get approval?
Thanks for responding... That would be positively great if the insurance company approved me within a week or so... I am hoping I would be scheduled for surgery in September... if I am approved... Thanks!
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How long did your process take to get approval?
Thanks for the info. Yes I already called my insurance company before I started all of the medical appts and they said they did cover weight loss surgery and to include lapband. My husband works for a large company and they even have a dedicated call number just for the employees and their families. They said all I need to do is have it preauthorized/preapproved just like I would if I had any other surgery. Keep your fingers crossed for me as I am so nervous about the approval.
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How long did your process take to get approval?
:redface:Hi Everyone, Just wondering what the general concensus is on after you did all of your appointments - how long it took for them to submit to insurance and how long insurance took for approval. I finished all my prereq appointments on Friday. I wonder if I should call my surgeons office on Monday and ask them how long will it take to gather the whole package and send to the insurance... I have Anthem BCBS PPO and I live in Virginia. I am so nervous - I need your prayers! Thanks for reading!!!!!!!!!!!
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BMI 39-bcbs of north carolina
I am sure you will be approved... cause if they said you didnt do the nutritionist or psych eval - then you would have def been denied... I am praying for you!!!!!!!!!
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Approved !!!!!!!!!!!!!!!
I am so happy for you! That is terrific news!
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Approved!! Well sort of
I had my remaining appointments done this week so I guess I will call the Drs office on Monday and see when they will send the information to the insurance company.. Please keep me in your prayers... I so hope I am approved for surgery... Thanks everyone!~
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BMI 39-bcbs of north carolina
I will pray for you to get approval. Please do the same for me... I am so scared of this process but anxiously hoping to get the surgery... Keep us posted!