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Horizon BCBS of New Jersey question about submitting paperwork

Careysgirl

By Careysgirl, in Insurance & Financing

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Careysgirl    20

Careysgirl
Posted

I'm sure this question has been asked many times but I'm asking again because my surgery is scheduled and I'm getting nervous.

How long from when insurance company gets paperwork does it take for approval or denial? 48 hours, a week, a month??? Somebody give me good news.

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Careysgirl    20

Careysgirl
Posted

I'm sure this question has been asked many times but I'm asking again because my surgery is scheduled and I'm getting nervous.

How long from when insurance company gets paperwork does it take for approval or denial? 48 hours, a week, a month??? Somebody give me good news.

Well for anyone who read my post I would like to report I got a call last night from my patient navigator and she said BCBS approved me. I was shocked at knowing it only took literally 24 hours.

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lasmith0802    67

lasmith0802
Posted

That's good news I have Horizen BCBS of NJ as well, I'm only on month 4 of my medically supervised diet. My bmi was 40 with no other conditions. I'm nervous they will deny me. I have lost 21lbs so far. How much did you lose? Did you happen to have and other medical conditions?

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Lolaj5    0

Lolaj5
Posted

I have Horizon BCBS NJ also but I have been waiting for 7 days so far. Hopefully I will get an answer soon.

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Careysgirl    20

Careysgirl
Posted

I had high blood pressure and sleep apnea it now 11 days post op and I lost 14lbs and feel great!

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lasmith0802    67

lasmith0802
Posted

That's awesome! Keep up the good work. I meet with my surgeon for the first time on the 11th next month. Fingers crossed

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Careysgirl    20

Careysgirl
Posted

Horizon BCBS has a high rate of getting fast approvals I was approved in 24 hours

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cdeisroth    420

cdeisroth
Posted

Hi

I have Horizon BCBS and I was also approved in 24 hours. I was also not required to do a 6 month medically supervised diet. I just had to prove that I had dieted at some point in the past 12 months with a letter from my PCP. I started this process on January 19th by going to a seminar and just had my RNY 4 days ago, March 14th. At home recovering now.

My starting BMI was 47 and I was 43 on the day of surgery. I believe they go by your starting BMI.

Good luck!

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Lolaj5    0

Lolaj5
Posted

I wish my approval was that fast, I'm still waiting. They said it's under review. I'm a little worried that I won't be approved since it's taking longer.

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Careysgirl    20

Careysgirl
Posted

Call customer service to check on status that speeds things up.

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Lolaj5    0

Lolaj5
Posted

I called today, it took them 30 mins just to find it. They said it's still under review

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cdeisroth    420

cdeisroth
Posted

Did horizon bcbs of nj require any documented weight history?

I believe my PCP included a 2 year documented weight history in my letter of medical necessity. I mentioned to her that I had been obese since age 12 so she included that phrase in the letter as well.

If you don't have a PCP you can get your weight history documented from any physician you have visited in the past couple years.

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Careysgirl    20

Careysgirl
Posted

Yes they required 6 months but it didn't have to be medically supervised I had 4 months weight watchers and 2 months from NUT at surgeons office.

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