Waiting on approval from BCBS of IL

[SarahLovy 6]

@@thinner-me I am also playing the "try to get it done before school starts" game (although on the student side). I am going totally nuts with the waiting! I have insurance approval, I am just waiting for my bariatric center to get their act together. Good luck with getting yours approved in time!

[Running2theSleeve 40]

I have BCBS IL.. My only requirements per my plan is BMI>40 and psych clearance. I have appointment with psych 7/21. I asked my surgeons office if they can submit for approval after psych appt and clearance and they said no. I have to have all orders cleared which is the surgeons requirements i.e. EGD, Pulumary, etc. Is this a common practice ?

[downsizingdebs 61]

I have bcbsil/anthem they approved mine in one day with High bmi psych pulmonary and cardio clearance. Make sure your surgeon office has sent it, they should approve it super fast.

Edited July 17, 2015 by downsizingdebs

[LessOfMe0503 157]

I'm a teacher too (in NC) and finally have my surgery date! I'm set up for Aug 3. It's cutting it close but I'm going to make it work!

[thinner-me 160]

I have BCBS IL.. My only requirements per my plan is BMI>40 and psych clearance. I have appointment with psych 7/21. I asked my surgeons office if they can submit for approval after psych appt and clearance and they said no. I have to have all orders cleared which is the surgeons requirements i.e. EGD, Pulumary, etc. Is this a common practice ?

I had to have everything except the EGD and Pulmonary. Usually the anesthieologist wants that right before surgery.

[thinner-me 160]

I'm a teacher too (in NC) and finally have my surgery date! I'm set up for Aug 3. It's cutting it close but I'm going to make it work!

I would go with August 3rd also!! Congrats!!

[thinner-me 160]

I have bcbsil/anthem they approved mine in one day with High bmi psych pulmonary and cardio clearance. Make sure your surgeon office has sent it, they should approve it super fast.

I'm not worried about the insurance company time wise as much as this office! I had everything in about a month ago. And we are just now getting around to sending it for approval! Ugh!

[Running2theSleeve 40]

@@thinner-me ... I feel the same way! I'm more worried about the office. I had my initial consult on 7/6 and was told I would receive a package with orders and each "specialist" name and number to schedule appt. Well it's 7/16 and still no package (I'm 20 minutes away from office). Called yesterday to follow-up .."oh your package was sent today." I'm like really do you know how long it can take to get an appointment with these doctors. So, she gave me the numbers to start calling. Was only able to schedule 2 out of 5 because the others said they need the orders and it's not in their system... Really Wtf.. I don't want to do the surgey around our favorite holidays ..Halloween, thanksgiving, Christmas - plus my bday and others.. Just ready to get this going .. Sorry for rant!

[downsizingdebs 61]

I arranged my clearances all on the same day as my surgery consult. They got my results in a day, sent to insurance the same week as well and was approved in a day by insurance. A lot of these surgeons go on vacations around the holidays so be pushy if need be and get it taken care of. If I were you I'd talk to the insurance and know their exact requirements, do those asap to get approved. If the doc has additional stuff he wants you can just get those before the surgery date.

Edited July 17, 2015 by downsizingdebs

[OutsideMatchInside 10,166]

My doctor submitted me to BCBS before I had all my clearances. I had not completed cardio. In fact my Dr office did not have all my information from Cardio until a week before surgery, even though they had the clearance from cardio a couple weeks before that.

The clearances are for your doctor so they know the surgery is safe. The insurance requirements are different.

I was able to have surgery in less than 2 months after seeing the Dr for the first time because the office had it together and got my paper work submitted quickly.

Call the office and stay on them, or switch Drs. They work for you.

[thinner-me 160]

Good news! I called Blue Cross today and after 4 people and over an hour on the phone, they were able to tell me that my papers were there for approval, but they had been put in the wrong place!! So it was good that I called them!! Why is everything a struggle?! Now we have to see how long for approval and if they can actually get me in within the next two weeks. Doubtful. But I'll just wait it out and see!

[Running2theSleeve 40]

Good for you! Now you're almost there! Pretty soon you'll be day 1 post-op!

Well wishes

Edited July 22, 2015 by Running2theSleeve

[thinner-me 160]

I go back to school the 17th of August. What do you think is the last possible date for surgery where I would be good enough to go back to work that day! No students that day or the next. Students on Wednesday the 19th. I was thinking Aug 7th is my last chance! What do you think?

[OutsideMatchInside 10,166]

It depends on how much you have to walk. Is your classroom air conditioned? Do you have to stand all day to teach?

You are going to be tired. I have a lot of energy but I get tired in the afternoons and want a nap, I am not drinking coffee either, so that doesn't help. I used to have a cup in the afternoon as a pick me up. The heat drains my energy.

Probably the 7th. I mean it really depends on your recovery. What is your pain tolerance like? The 7th is probably the safest. Maybe the 11th pushing it.

[thinner-me 160]

My room is air conditioned. I do stand a lot but could probably sit more for the first week or so if I had to. I have a pretty high pain tolerance. I have to to and live with pain all the time. Lol!