Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Scheduled surgery while waiting for approval?



Recommended Posts

Hi everyone. I was wondering if some surgeons schedule the surgery while waiting for the insurance to approve. i would hate to wait up to a month for approval from bcbsnc and then wait another month for my surgery to take place.

Share this post


Link to post
Share on other sites

Every insurance/surgeon process is different. I got my date after approval. Way after approval. But someone else's experience is probably entirely different.

Good luck!

Share this post


Link to post
Share on other sites

My surgery was scheduled the same day they submitted to insurance. I don't know if they always do that or if they did that because they know I am trying to get my surgery in before school starts back up. It might depend on your insurance. My bariatric coordinator is extremely knowledgeable about my insurance company. She said they process a lot of claims through BCBS.

Share this post


Link to post
Share on other sites

I also have BCBS and I am hoping and praying they approve me!!!! Send positive thoughts my way! Say an extra prayer! I can't keep living with this GERD! Good luck!!!! Let us know when you get approved!

Share this post


Link to post
Share on other sites

Mine wouldn't even contemplate setting a date before approval. And it's a good thing they didn't, since my revision approval took forever because SAMBA/Cigna was being a pain in the you-know-what about approving it. It took almost 3 months for just the submission/denial/appeal/denial/appeal/peer-to-peer/approval process, not including any of the pre-submission hoops that I had to jump through. Now I have to do my medical clearances, but I'm hoping to talk them into setting a date so that I can request time off of work and get my mom a plane ticket to come and stay with me.

Share this post


Link to post
Share on other sites

Just got my call today that I was approved for my revision from sleeve to bypass! Was submitted to BC/BS PA only 2 days ago! I was approved because I have stenosis with SEVERE GERD! Surgery date 8/31... Good luck everyone waiting to hear..

Share this post


Link to post
Share on other sites

Bcbsnc I was told you have surgery first, someone told me as long as you got bypass on your coverage all u pay is copay I have same company buy can't afford copay :( so I'm waiting and I have to see what my new surgeons take :(

Share this post


Link to post
Share on other sites

I am scheduled for surgery on Aug. 27 and have still not heard back from insurance. The nurse at Anthem has sent my case to the physician at Anthem. I have my pre-op and final appointment with my surgeon...I hope. I am going to be devastated if denied. Anyone else experience anything similar?

Share this post


Link to post
Share on other sites

I have a tentative date --it was 5 week after the date of submission, but she said if it came back right away they could try and make it sooner--

Share this post


Link to post
Share on other sites

I am still in the process of gathering all the info I need to get approved. My last NUT visit is Dec 1 and surgery is scheduled for December 15. I'm praying for a fast positive decision. I guess it depends on the surgeon.

Share this post


Link to post
Share on other sites

I was given a tentative date of Oct 5th while waiting for approval. One thing I can say- is be persistent! I kept calling my insurance company to see if my Dr's office had submitted, and finally called my Dr's office and raised hell. The squeaky wheel gets the grease!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×