Hello everyone,

I am in the process of completing all the criteria for my insurance (BCBS TRS Active Care) approval for my band. I have completed the psychological visit, I have one more visit to the dietician this week (YEAH) and my bmi qualifies me for the band. So far, my surgeon's staff has been great. Since I work at a high school with special needs students and I am required to lift them. I want to make sure I am completely healed before I return to work mid August. How can I make sure all of my paperwork is submitted correct the first time and some suggestions on how I can get the insurance to quickly approve me. I'm praying that I can have my surgery by June 30th. Any suggestion will be helpful!

Thanks

You are on the right track by making sure you have all your appointments done quickly. My insurance approval went very quickly. There are a few things I did that might have helped keep it moving along.

1. I called my insurance company and had them read the exact requirements for my surgery to me. I know the surgery center did it, but I wanted to make sure that I had it down specifically. There was one difference between what they told me and what insurance said. So, I called back and talked to three people to be sure. This saved me at least a week because the surgery center believed that I had to have records of weights from the last five years from my doctors. That wasn't on my policy so I insisted that we file without that. In a hurry here.

2. I stayed in touch with my provider to see that it had been submitted. It took several days to get it submitted and I made it clear to them that I was on a time crunch due to my work schedule so this might have helped a bit. As soon as they told me it was submitted, I started keeping in touch with my insurance. Once it was faxed to them it took a couple of days for them to be able to even see it had been received.

3. Once my claim was received I called several times a day to see where it was in the process. I learned the process from anyone who was patient when I called. They did tell me that I had a right to call as often as I wanted to. They told me that they had to make a decision and notify us within 15 calendar days of receiving it, but my estimated surgery date was before that and if it wasn't done two days before that date they would escalate it. This estimated date was not even scheduled, so that was a help to know.

4.On one of these calls they gave me a number for this case. Try to get that and it will make your calls go much faster. Also, knowing what date the doctor has entered as your surgery might help

5. When I finally was told that it was approved (I had called twice this day but at 4:00 I got the word), I got the approval number and called the surgery center. They only check twice a week on Tuesday and Thursday and I got this on Thursday after they checked. So I called them and gave them the number. At this point they got on the ball and I was in surgery within a few days!

In summary: Stay involved and remember that it is your insurance company. There is someone there who will talk to you.

Thanks for replying! I plan on harassing the insurance company until I get an approval!