I' m so upset. My surgery was scheduled for Nov.9 but I received a call this morning that it has to be cancelled. Per my doctor's office, my insurance company will not approve the surgery because the hospital is not a "Center of Excellence". My insurance is Blue Cross Blue Shield (Anthem).......Extremely frustrated. Anyone else had this problem?????

no - I have BCBS fed and I don't know about if the hospital I had my surgery at was a "center of excellence". as far as I am concerned they were AWESOME!!!!

Why was your surgery scheduled before insurance was approved? My doctor's office wouldn't even put me down for a tentative date until my insurance approval came back. Regardless, this seems like a requirement you should have known about at the beginning.

I'm so sorry to hear this. It amazes me that they couldn't have figured out there was a problem way before now. Hope you're able to work something out. Good luck!

Why was your surgery scheduled before insurance was approved? My doctor's office wouldn't even put me down for a tentative date until my insurance approval came back. Regardless, this seems like a requirement you should have known about at the beginning.

I agree. How could they schedule without approval? That would be a HUGE red flag for me.

You don't say what state you're in, but I do know that here in CA, the health plans all have specific hospitals they stipulate as Centers of Excellence - they are the facilities where the volume of surgeries done and the outcomes reported are better than in other facilities.

I just can't believe that your surgeon's office didn't know this up front, this is the sort of thing that anyone involved in getting these approved knows backwards and forwards.

not approve the surgery- hospital is not a "Center of Excellence

@

i was told very early by insurance i must go to a Center of Excellence

found 2 hospitals that were COE

took it from there

finding a center of excellence hospital

shouldn't be too hard

call your local hospitals

if their is no one immediately around

you will have to check out areas around you

i was so excited to have surgery scheduled

i didn't think twice about having surgery scheduled before my approval

luckily i was approved

sorry for the delay

being told 3 days prior to surgery - OMG

the tears must have been flowing

hopefully you will be approved sooner than

i can only imagine how upset you must feel

good luck

kathy

Mine has that stipulation here in Ohio. But I knew about it up front and made sure the hospital was approved.

I would call the insurance company and find out what hospitals locally they would approve at. It may mean switching doctors, but the wait time should be close to nothing since you were already scheduled. I'm so sorry. I know how upsetting and frustrating and heartbreaking it is. Don't lose sight of your goal -- keep to a light diet - and before you know it, you'll have a new (and approved) hospital!

I' m so upset. My surgery was scheduled for Nov.9 but I received a call this morning that it has to be cancelled. Per my doctor's office, my insurance company will not approve the surgery because the hospital is not a "Center of Excellence". My insurance is Blue Cross Blue Shield (Anthem).......Extremely frustrated. Anyone else had this problem?????

Anthem BCBS specifically states that the hospital must be a Blue Distinction Center of Excellence. You can log into your online account and check to see which hospitals in your area fall under this designation. You can also check to see which doctors are affiliated with those hospitals.

Hope this helps.

Good luck!

You can search blue cross blue shield center of excellence for bariatric surgey and a list will come up with hospitals in each state. I know my insurance will cover my surgery completely if I choose one of these hospitals and only a portion if I go to a hospital not on the list. Good luck

Edited November 4, 201510 yr by baileyj908

From what I have read in this group many Dr's pencil their patients in on their surgery calendar prior to approval.

Mine has me penciled in pending insurance approval. Dec. 18. He only does surgeries there on Fridays & the next two Friday's of the year are holidays. So, they wanted to get me on the schedule.

Also, my insurance, BCBS, also suggested that we send all records after my 2nd nutrition visit, next Friday, since they can take up to 30 days to approve. My last nut visit is December 11 & I am needing surgery the following week! That way they can review everything pending that last appt & will know sooner if it's a go or a no go.

From what I have read in this group many Dr's pencil their patients in on their surgery calendar prior to approval.

Yup, I'm scheduled for December 1st but my insurance hasn't approved it yet. I asked my surgical coordinator about it and she said the 2 weeks is plenty of time and they rarely have any issues with my insurance. I'm prepared for them to have to move it back but if they don't then I'm ready!

I had a similar experience however the hospital I started with actually lost their "center of excellence" status right in the middle of my pre op stuff. Had to start all over at another Bariatric Center 6 hours from my house . But the good news is that my surgery is November 16th and this liquid pre op diet sucks!!!

Edited November 8, 201510 yr by tinkrmybells

From what I have read in this group many Dr's pencil their patients in on their surgery calendar prior to approval.

Yup, I'm scheduled for December 1st but my insurance hasn't approved it yet. I asked my surgical coordinator about it and she said the 2 weeks is plenty of time and they rarely have any issues with my insurance. I'm prepared for them to have to move it back but if they don't then I'm ready!

I was told the same thing!