Submitted!

2b-banded · October 17, 2008

Ok, so I called my Primary care MD's office to see if they had the results back on the two tests my surgeon needed that doc to order prior to being submitted to insurance. Turns out the results were back, and they were in the process of being faxed at that moment (so the assistant said, and you could hear the fax machine do that "fax done" beep in the backgroud, so SOMETHING was being faxed). I called my surgeon's office to see if the EGD had to be done prior to submission, or just prior to the actual surgery. The insurance coordinator called me back about 5 minutes later, and said she missed my call because she was sending paperwork on several patients to my insurance company, including me!!!! She also said that my insurance plan has a policy that the decision has to be issued within 1 week.

ACK!! I'm so nervous, and excited, and scared, and nervous! Did I mention nervous? I had talked with someone in the Bariatric Management Department a few months ago when I was having Helluva time getting the Bariatric Program at the hospital to call me back or set up an apointment, and they said that based on the info I gave, I would be approved, if the surgeon said ok. I even called back a few times and talked to a few different people in the department, who all said the same thing, so now I just have to wait for approval to get my date set. I'm trying to get the surgery done before the end of the year, because insurance changes Jan 1, and I'd have to pay deductable again, which will be higher, and pay a higher co-pay and percentage of the surgery. Looks like it will be about a $1500 difference, which would absolutely SUCK!!! Not to mention I've been trying to get this done since LAST November.

So anyway, wish me luck, and I'll let you know how long it takes to get approved or denied, as well as when my surgery is.

Jesangel76 · October 17, 2008

I hear ya! My paperwork was sent to my insurance company a week ago and it takes two weeks for them to determine if I'm approved or denied. I have a week to go and I am nervous that they'll say NO. which shouldn't be the reason b/c I did all I had to do and I qualify. So, I'll pray for the both of us!!! :smile:

ksill18 · October 17, 2008

same here. My paperwork was submitted last friday. every time my cellphone rings I get so nervous. hope I get a call soon with the :smile:

2b-banded · October 18, 2008

I called my insurance company yesterday, and they said they had not received anything on me. She even put me on hold and said she went to go check if it had just not been assigned to anyone yet for review. So I had to call my surgeon's office back and ask that they send everything again, because Humana said they didn't get anything, and to request a confirmation of receipt, since that's what the Humana rep said to do. So now I'm worried it didn't go, and I'll have to wait even longer! I know, I know, a lot of insurances make you wait 4-6 weeks or longer. But I want it done now! I'm trying to get everything done, so I can get the time off scheduled this year, and don't have to promise the world to get people to trade shifts with me.

2b-banded · October 24, 2008

make that APPROVED!!!!!!!!!!!

Yippee!! I haven't been scheduled yet, but it's looking like mid to late November, or first week of December.

If it's December, I'll have vacation time to take, if it's November, I'll have it sooner, so win-win!!

:smile:

Jesangel76 · October 27, 2008

Well I guess my prayers were answered b/c I just got approved too! Hooray for both of us! I get banded on 11/24, which just before Turkey Day, but oh well!! :thumbup:

Good luck!!!