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Hoping for a quick approval.....

ereese310

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seeingme    91

seeingme
Posted

I'm also with BCBS of MN, and mine was submitted on Sept 27th. I haven't heard anything yet. The waiting was killing me. I was shooting for surgery the first week of November, but that's not likely to happen now. GAH!

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lataip21    2

lataip21
Posted

You never no u can still make it stay on top of your insurance and dr i had to because i needed to get approved by the end of the year to approve at 100% just stay positive and pray

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NJ Mom    30

NJ Mom
Posted

I have my last appointment today and my surgical coordinator will submit to insurance today for approval. I am tentatively scheduled for Nov 9 surgery

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goodies110187    0

goodies110187
Posted

Insurance questions!!! I am losing it. I live in Florida and have Florida Blue. So I want to do the VSG surgury. I google a place and call them and give them my insurance info. She calls me back and says my insurance doesnt cover Bariatric. Frustrating as I have like the best plan you can get through my job and always get comments about how good my insurance is from Dr.'s offices. So, I lost hope. Then I asked my HR about it and she emailed our contact with Florida Blue asking. The women tells her that she recommends that my provider call Florida Blue to get an exception, that she has seen in "rare instances" it get approved when sent for an exception. Which is foreign to me. I got to my primary to ask and she is 100% on board and very familiar with this process. I also go to the Florida Blue site and see there whole section for bariatrics and I know you have to qualify and jump through hoops to get approved. Any advised. I need help Im loosing it. I was gonna ditch my place with my job for health insurance and get my own if not. Why is this seeming to be far fetched!

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thmitchell    17

thmitchell
Posted

Chylyn,

Did you receive your fast approval from BCBS Illinois?

Thanks,

Racshelle

I have bcbs Illinois and my paperwork was submitted October 3rd and I got approval today. So about a week for me! I am just wondering how long it will take to get the actual approval letter!

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hudjess    95

hudjess
Posted

@@ereese310 why did you get denied? Did they say anything? I'm sorry to hear that.

Well I did not get a quick approval, however I did get a quick denial. This is so upsetting. I wish I hadn't called while I was still at work. [emoji20]


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ereese310    9

ereese310
Posted

This is the letter they were very quick to send me. When I started this process I was told the 6 month diet was not required, however, they denied me because I did not do the recommended six month diet??? I do t get it. I can appeal or do the 6 months and re submit.

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post-300148-14762932263923_thumb.jpg

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JAM72    16

JAM72
Posted (edited)

@@ereese310 - If you are going to appeal, I would also start on a 6-month medically-supervised program asap. It can't hurt to do so, and if it really is required, you will have gotten a head start on it (I think it can take 30 + days to process an appeal). I would be questioning why your surgeon's office gave you incorrect information about your insurance requirements. It also looks like they want you to address your GERD. Your surgeon's office should be able to guide you through all of this. They don't get paid unless they do [emoji6]

Edited by JMill 72

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ereese310    9

ereese310
Posted (edited)

I don't even have gerd lol, that's a diagnosis from my pregnancy 2 years ago. I'm hoping all of the appts I've had with my dr, surgeon, and nutritionist would all be able to count as weigh ins that count toward the 6 months. I called and asked my insurance why they are telling me I need to do the 6 month diet when I've already been told by my insurance that I didn't have to. She said it's not a requirement, it's a recommendation. Insurance really is a joke. Why am I paying 500 a month so they can deny all my requests for care. All appts with the nutritionist are automatically denied payment because they cover the surgery, but will not cover the appts necessary to fulfill the requirements for surgery. Sooo very frustrating.....But at the end of the day, it's not anything every other person on the planet isn't dealing with. I'm going to call the Bariatric office tomorrow and see how they suggest I proceed with it all.

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Edited by ereese310

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seeingme    91

seeingme
Posted

I'm also with BCBS of MN, and mine was submitted on Sept 27th. I haven't heard anything yet. The waiting was killing me. I was shooting for surgery the first week of November, but that's not likely to happen now. GAH!

Well...I called BCBS to see if that approval letter is coming soon. They claim they haven't even received the request! My doctors office verified it was sent on 9/27. So they're sending it again, which pushes me out another 3 weeks. I still have to have the appointment with the surgeon (after approval is received) so I can get on the surgery schedule. I guess it won't be the beginning of November.

I try...try...try and try some more, to remind myself that everything happens for a reason, even scheduling problems. Still hard not to get frustrated when you spend months in preparation with a goal in sight!!

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Racshelle    17

Racshelle
Posted

Thmitchell

Thanks for your response. My file was submitted on 10/10. I had been calling

everyday to see if there is any new progress. Today I spoke with someone who

without directly saying so inferred that I should not call everyday. She also said that many requests were submitted lately. I am glad that you received

your approval yesterday. Hope I will receive my approval very soon.

Racshelle

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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