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Bcbs Il More Info Needed

The doctors office submitted my info last tuesday to insurance, today (Mon) I called and they have sent a letter requesting from the surgeon my history and physical. Anyone else have experience with this? I am waiting to see if this is something they already have or something I need to go do. Thanks,

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  • Got my approval via telephone and fax today! So happy! I can now move on and to the Pre-op boards and quit calling the poor ladies at BCBS everyday!

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When I was waiting for approval, I was told by the nurse with the ins that they needed more info about my weightloss history. I asked if she needed that from me and she said she had requested it from my surgeon's office. It may have delayed the process some, but I was approved after 2 weeks. So, it's not unusual.

Yes, h&p is something standard that they request. My doctor had a list of stuff I needed to do so I can submit them to ins and that was one of them.

My insurance required a history but a physical was not required.

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I have not heard back from the surgeon so I am thinking they have this info already. I will be making another call to them today!

That should have been submitted with the packet. That's a normal requirement.they must have forgotten it.

  • Author

Thanks for your input everyone. The insurance company said my packet was 17 pages long before the history and physical request. I guess the psyc doc wrote down every word I said!

I called today and they have it now. Now I wait again. I just have to be approved. I read the policy back and forth, and looked for a way to disapprove me. I met the requirments. My BMI is 40, I am over 18, I have stopped growing, I am of sound mental mind to make the decision to do this, I do not have another chronic disease that would advise against wls surgery. I have done the psyc and nut visit. What am I missing? If I meet their criteria how can they not?

I have BCBS and I was very worried about being denied because my BMI hasn't been >40 the whole past 5 years (I've done boot camp and Dr assisted diets and lost to below 40). BCBS had to have a H&P from my primary doctor listing any health issues and my weight/weight loss attempt history. They also sent back the first submission because I hadn't had an "official" appt with my surgeon (he usually waits until after approval for that). We re-submitted around July 5. I received a phone call on the 7th, while i was out of town, from the surgeon's office saying I was approved. When I got home I found a letter saying I had been denied! But turns out they just hadn't got all of the fax from the doctors office. Next day my approval letter came!

I hope you hear back soon and good luck!

  • Author

Got my approval via telephone and fax today! So happy! I can now move on and to the Pre-op boards and quit calling the poor ladies at BCBS everyday!

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