It's In Review?

jasmin20 · December 6, 2008

I have BCBS Fed and my paperwork was sent to them on Nov. 26 I called them yesterday and they told me that it was in review. What does that really mean? I'm new at all of this so I have no clue.

winthropgrad08 · December 6, 2008

It's pretty simple, they're just reviewing what you or your surgeon submitted to see if you qualify. I too have BCBS Federal insurance and it took about a week to get an answer. I'm not sure what you submitted but with my information submitted it included my complete blood work, Xrays, psych eval, nutrition counseling, seminar information, surgeon and family doctor recommendation, pulmanory clearance, and my Upper GI clearance. A lot of the things I listed were not required through my insurance but through my actual surgeon. All that my insurance required is that my BMI be over 40 and that I have a psych eval and a surgeon recommendation.

After my first approval, last minute I changed my surgeon along with the hospital. I've gone through the approval procedure twice.

Each plan is different so I'm not sure which will apply to you. The entire process takes about 2 months, from you initial visit with your surgeon to your actual surgery date. But then again every surgeon is different and may require less or more time.

Just be patient and things will work out. This is a serious surgery and every precaution should be taken. Good luck and I hope this was helpful!:thumbup:

jasmin20 · December 6, 2008

thanks that was helpful. I see u are from Ga. too so were going through the same BCBS. The only thing my Surgen did was typed up a letter stating my BMI and my health history thats about it. They really didnt do anything, they just asked a few questions and typed the letter.

LISAMARIE1158 · December 6, 2008

Hi Jasmin..l too have Federal B/C and B/s.. my paperwork sat on someones desk for over a month, until l called daily to see when it was going to move..after calling so many times l actually ran into someone on the other end of the phone who had bypass surgery several years ago..she understood how important this was to me...l would recommend calling daily...lf not you may end up like me, waiting and waiting for someone to do their job....Good luck to you and hope it all goes well...l couldn't be happier..

jasmin20 · December 7, 2008

I have been calling maybe two times a week but now im going to bump that up and call everyday ilke u said.

winthropgrad08 · December 7, 2008

I just can't believe BCBS is giving you the run around that much. It's obviously not that unbelievable since they are insurance but I had no problems what so ever. Not sure why but maybe going to your surgeons just wasn't enough for them. My doctor didn't leave any question unanswered. I find it kind of ackward that your doctor doesn't want you to get any type of clearance from other specialist. But they're all different and they all take their own level of precaution. I really hope everything follows through for you.

LISAMARIE1158 · December 7, 2008

Hi Winthropgrad08, l think its bec it FEDERAL b/c b/s....they are buggers...after all the time l waited then they denied me, to approve me the next day....l was told by my Dr that the Federal B/c was the worst to get an approval from...

winthropgrad08 · December 7, 2008

I have Federal BCBS and had no problems. In fact, they were very helpful with anything I needed when I called. My doctor told me that they were one of the easier ones. What he also said was that BCBS for STATE employees was horrible and that they do not cover most bariatic procedures.

changing · December 7, 2008

a friend of mine has bc/bs of ga the federal kind and it was approved.she stays here in albany.she looks really good.she just had to pay a small portion.

bklyn1984 · December 8, 2008

I too have BCBS Federal and I was approved in less than 48 hours. My surgeon's office had their own list that I had to follow even though it was not required for the insurance approval.

I had to get clearance from my primary, my pulmonary, and I had to see a cardiac doctor too. Then I had to have a chest x-ray, blood work, upper gi, and ultrasound of my gall bladder. I also did a sleep study and it found I had moderate sleep apnea. Because of that I also needed clearance from the sleep doctor.

I never thought I would be approved so quick based on what others said here and in support. I hope that you receive an answer very quick. Stay on top of them and do not give up.