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

Sorry but yes I have another insurance question



Recommended Posts

It would nice to have it approved real quickly.A lot will depend on how fast they can get all the stuff together and sent in. I would talk to the doctors office. Also see if you can have them fax or offer to pay to have the stuff overnighted to the insurance company. Get a person who can approved it. There will be a lot of people going on Vacation for a couple of weeks right about that time. Also what has the doctors office said, is the doctor going to be on vacation? Maybe it would be better to plan to do it right after first of the year unless you have all ready meet your ded or have a lot of expenses. Just a thought. Good luck with it. I hope that the letter I forwared to you will also help.

Chris

Share this post


Link to post
Share on other sites

Yes, your letter was very helpful. I already have everything together needed for them to send in except my december visit to the weight loss doctor. They already have my h&p that the surgeon did, and my 3 years of weight loss.

I will def ask them to fax everything in...I didnt think about that.....oh and yeah after the first of the year my insurance changes instead of them paying 100% they will only pay 80% and plus i will have my ded. Thats why I REALLY want to get this done this year.

Share this post


Link to post
Share on other sites

The anticipation is killing me!!! I can finally submit my request for the surgery in 10 DAYS!! So, I call the surgeons office today to make sure they had everything..and was talking and she said yeah the surgeon could do the operation this month but that most likely BCBS wont approve it before the end of the year bc they know I will have to pay a deductible come January...and then I will also have to pay 20% this really bites!!!!!!!

Share this post


Link to post
Share on other sites

Good Luck! Try finding out if your surgeon even has an opening at that time, and explain to the scheduler that if at all possible you want to be scheduled before Jan 1, 2008.... even if it means you go on a cancelation list....... 20% is 20% and is worth the shot! After your doc submits call the 800 on your card and ask for the determination department and follow up with them, try and find out who will be assigned your case and then make sure they are not off for the holidays and politely STAY ON THEM!!!!!

GOOD LUCK!

Share this post


Link to post
Share on other sites

Yeah, I am scheduled for the surgery 12-27 if BCBS comes thru. I had planned on calling them 2-3 days after the submission. Thanks alot!!!

Share this post


Link to post
Share on other sites

Now my weight loss doctor is refusing to fill out my last form for my December visit. He filled out the other 5 months but wont fill out this last one....apparently he doesnt agree with the surgery...what the crap can he refuse to do that?? WHAT AM I SUPPOSED TO DO???? I mean I have been going there for 6 months...and all of a sudden he wants to be a jerk at the last minute...GGGGGGGrrrrrrrrrrrrrrrrrrrrrrrrrr:mad:

Share this post


Link to post
Share on other sites

Sorry to here about this set back. Did the doctor say why he will not fill out the form? Is it because you lost a lot of weight or what? Hard to image that he would have you go through all this and not approved. Is this your regular doctor or the lapband doctor? Have you tried to get back in and sit down and talk to him and explain how you feel about this and all the money, time, enegery and effort you have spent with this hole process. If you need any help we could start a letter campaign and hope that he will send it in for you.

Chris

Share this post


Link to post
Share on other sites

This is the weight loss doctor that I started seeing before I decided to have the lap band. But I decided to keep going there bc I had already started their program. He doesnt believe in gastric surgeries he said. But see he filled out the first 5 months of paperwork but wont fill out this last month. I asked the nurse well make me an appt so that I can see him she said the first she had available was 12-28 well HELLO I said right now I am tent. scheduled for surge 12-27 but they dont care...so I had my surgeon request my records and I hope that that will be good enough.

Share this post


Link to post
Share on other sites

Well, the time has finally come. I will take the rest of my info to the surgeons office today. They will fax everything to BCBS of Al tomorrow. I called BCBS and asked if they ever put rushes on approvals. And I explained everything to the lady--she just laughed and said that I needed to expect at least a 30 business day wait.......oh well.

Share this post


Link to post
Share on other sites

I just called the surgeons office to make sure that we def had everything and she is actually submitting my request today...I am sooooo happy!!!:clap2:

Share this post


Link to post
Share on other sites

Does anyone know another number to BCBS of Alabama besides the general customer service number? These ppl that I talked to yesterday dont seem to know what they're talking about. They said they have not received any of my paperwork. And then they said that it would need to be refaxed for medical review....which we did yesterday. How in the world did some of you get approved so quickly when I cant even get to talk to anyone that says they have even received my papers (which were faxed last thursday and yesterday.)

Share this post


Link to post
Share on other sites

I would suggest that you get a person name, phone number and fax number. Also get a complaint number that can be put on the fax and paper work. My wife and I had the same problem with United Health Care but once we had that the doctors office was able to resend and obtain approval. If you have any questions just e-mail me or ask on here.

Chris

Share this post


Link to post
Share on other sites

I had the same problem its two different dept. Customer Service and Care Coord. dept. and customer service can't see certain information, so I would said make sure you are contacting the correct dept. ask to be transfer to a Care Coord.

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

    ×