Waiting to Exhale

[OldMomOf3 52]

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Edited February 2, 2015 by MomOf3InOC

[Catherine Gray 11]

Finally after 1 month! I will be gettir my surgery date. Office manager was blown away byb the unprofessional attitude of the surgical scheduler! She said being as though I got denied by primary, secondars will not pre authorize. All I do is submit the eob from primary with claim and secondary pays the entire bill. Woooo hoooo! Always advocate for yourself. Never take no for an answer.

[mrsmith901 18]

Hi Mrs. Smith,

I'm on the exact same schedule you are on - Feb 6 EGD, the next week my final consult. Then after that I have to wait and see if I am approved. It is uncertian BC my BMI is too low right now (thatnks to the band, but still...) I'm hopeing to have conversion band-sleeve on or before March15 because after that date my insurance changes and I would have to do the 6 month diet. What is your desired surgery date?

I am hoping to have it done by the end of February! I am ready to be over this part of the process Good luck on your insurance approval! Hopefully everything goes smoothly here on out for us both!

[Sharon1964 2,530]

Finally after 1 month! I will be gettir my surgery date. Office manager was blown away byb the unprofessional attitude of the surgical scheduler! She said being as though I got denied by primary, secondars will not pre authorize. All I do is submit the eob from primary with claim and secondary pays the entire bill. Woooo hoooo! Always advocate for yourself. Never take no for an answer.

Please, please double-check this with your insurance company. In all my years in the medical support field, I have NEVER seen it work this way. Perhaps your insurance DOES work this way. In my experience though, if the primary denies, the secondary will ALSO deny because the primary denied.

Your insurance MIGHT have a clause that says if your primary denies for not being covered on the plan, they will pay as if they were primary.

I would not only call my secondary, but I would probably record the call.

[Catherine Gray 11]

Thats exactly what I have. Everything is in writing.Im in nj, thats how my particular insurance works. Thanks for the tips too! I've been speaking with insurance for several months prior.I had it down to a science. For some reason Horizon NJ will does not require a pre-auth

[Mrs. Reid 392]

APPROVED! APPROVED! APPROVED!

[mrsmith901 18]

Congrats!!!!!

[mechele8 63]

Congrats on the approval!!! I'm waiting now but it's only been a week. It feels like it's been much longer. I just decided to stop focusing on it because my anxiety is causing me to snack on junk food. I had to let it go. I'm trying to stay away from those bad habits.

[Engteacher 158]

I'm so happy for you! I've been watching your story for a few weeks, because I have Preferred One like you do and I'm from MN as well. Be sure to let us know when you set your date. I'm aiming for early June.

[Mrs. Reid 392]

Preferred One is known for being barbaric friendly - for the bypass not the sleeve. It just took a long time to get things done....but a lot of that had to do with my insurance person at Hennepin County blowing me off. Are you going for the bypass or the sleeve.

[Engteacher 158]

Not sure yet. I'm leaning toward the sleeve, but haven't met with my surgeon yet. When I talked with Preferred One, they said they covered both. Clearly, you've been twisting in the wind while they made the determination. I'm so glad the the wait was all worth it in the end.

[Mrs. Reid 392]

Got my date!!!! February 24, 2015 Got to meet with my doctor this Thursday, Pre-op on Monday and then start my 2 week pre-op diet on the 10th!! It has been so frustrating waiting!!!! Today I go into work and put in my request for time off!!!! Yeaaaaaa!!!!