Help

March 18, 2005

It is friday morning 3/18 at 10am and i am FREAKING OUT!!!!! I am scheduled for lap band surgery April 7th. I am 38 yrs old, with a BMI of 49. I have sleep apnea. My insurance co is BCBS for State of Ct employees. My insurance policy allows the surgery if "medically necessary". I also have letters of recommendation from my PCP and Gyno doctors. My surgeon's office handles everything and says they have had good luck with my ins and it will be fine. I am stressing because they have not approved it yet!!! They have had the ppwk for 3 weeks and three days ago asked for a copy of my psych _eval. I have a part time job that I need to give notice to and I am going to Italy for a month in July. My surgery is 2 1/2 weeks away!!

I called Blue cross and asked about it. They said it's "in review"......

How long will they drag this out?? People have told me that BC drags it out. Iwas upset and crying and asked the ins rep why they do this..... He probably thinks I'm nuts...... Is this normal to cut it so close to surgery????????? PLEASE HELP!!!!!!!!

DeLarla · March 18, 2005

Take a deep breath... I think you're really lucky that your insurance even covers the procedure. I have BC/BS and had to self-pay. But yes, they tend to lag around till the last minute (my crazy mother would say it's a goverment conspiracy to drive you mad.)

Alexandra · March 18, 2005

Kellyv, yes, this is totally normal. I think you're in very good shape, actually, since I know BCBS of CT has paid for banding in the past. If you're medically qualified for the surgery you shouldn't have a problem getting approved.

Be aware that approvals are typically only good for 30 days, so it's VERY common that they are only delivered within a week or so of the prearraged surgery date. Relax, and all our fingers are crossed for good news to come your way soon.

I'llsucceed · March 18, 2005

Hi Kelly,

Listen I was in your shoes just last wednesday. The insurance work had been in w/all the papers to BCBS Network for 3 1/2 weeks. The surgery date set for March 29. I started the liquid pre-op diet last tuesday. The reason the surgical office sets the date is because its hard to get on the calendar w/the doctors & the insurance Companys like to see that the date is forthcoming. It is so much easier for them to post pone the date & move it later in the month than to orginially set it. Your stuff seems in order & I am sure it will go through. Behaps you could talk confidentailly w/your boss & ask them for help on the time-off.

I hope all goes smoothly & your approved. I was not & am fighting for a rebuttal now. But my BMI wasn't as high. You I am sure will get your "yes"answer soon. This is normal.

March 19, 2005

Thanks so much for your replies!! I feel better knowing it has happened this way before.

Feel2Young2B40 · March 19, 2005

Hi Kelly! I was told the longer the insurance company has the paperwork in review, the better the chance it will be approved. My doctor's office said most refusals come back very quickly so you should be well on your way! Good luck and keep your chin up! Take care! Laura