Insurance question

Lu Ann · June 7, 2005

:paranoid

I have my first consult with Dr. Spivak this Thursday. Does anyone know how long it take generally, for insurance to make a decision if you are approved or not, after all the paperwork is submitted? I am still shooting (and praying) for June surgery date, but not sure if it is possible.

Thanks a bunch!

Alexandra · June 7, 2005

Hi Lu Ann,

I don't know about your state but here in NJ there is a requirement that insurance carriers deliver decisions within 30 days. In practice it's actually a lot faster. There's probably a similar time frame at work where you are. In my experience as an insurance broker, I've learned it's not the decision-making that takes time; it's delivering all the paperwork to the right people. Once that's done, I think you have a right to expect an answer within 10 business days and possibly a lot faster.

Good luck!!

okiejudy · June 7, 2005

I think that is a requirement in Texas too but my insurance keeps misplacing stuff. They have had it since April. When I called last week they said it had been misrouted. Is there anything you can do about incompetence?

Alexandra · June 7, 2005

Unfortunately, no, Judi, there is nothing to be done about incompetence. Just stay on them and make sure all your papers are received. That is really important, because weeks can go by and you'll call for a decision just to find out that one document got, as you say, misrouted. ARGH! I totally feel your pain.

sandie1958 · June 8, 2005

lu ann. i have united health care. they rec. my pap work last wed/ i had the approval letter sat in my mailbox but guess what / the dr office put the gastric bypass code instead of the lapband code & i caught it called them mon. so it has to be resubmitted. sandie