indi1

Feel better soon. Seems like all they have to do is walk by and they drop germs! :ack2:

jasleeve- I know how you feel. My request was sent to insurance on 11/22. I seem to be obsessed with this now. Its all I think about every day. I also call them at least every other day. ( Its kind of like weighing every day, which is not the best idea). You are fortunate to have a tentative date, my surgeon's office wont even consider a date until its approved. Hang in there.. you are not alone!

Thanks for your encouragement!

Yay!! Congrads!

So, the request was "bumped' back up to review to point out the missing documents that they apparently missed in the packet. My nice lady "Michele" was going to call me back when she heard they had looked at it again. Impatient of course, I called back today and apparently "Michele" has the case open and is the only one who can help me. No one else can do anything because its open with her. And, there is no way I can call BCBS and ask to speak to her directly. So, I'm kinda stuck on getting any status on this issue. Next point of confusion. I found a reputable surgeon in my area who actually had some openings this year. They took my insurance info, etc. I told them BCBS was reviewing my request. They call me back and say that they cannot perform the surgery because they are not a blue distinction location and BCBSIL requires this. So when I called to check on the first issue, I asked BCBS about this and they told me that my policy and my employer specifically, do allow surgery at NON blue distinction locations (as long as they are in the network) and that the doctors office was misinformed. I have no idea how to get the two different parties on the same page. So I just keep plugging along...

Bring it on! How I will enjoy going to a summer cookout, party get-together, whatever is being help outside and NOT sweating..

Well I called today to check the status and the nice lady on the phone said that it was not approved because they stated the paperwork only included 3 months of the 6 required. The lady on the phone pulled up all 38 pages and said that she saw all of it and they must have overlooked a page. Anyway, she "bumped" it back up to them saying they would see it in the morning and she would call me on my cell. So we will see tomorrow I guess. No matter how messy this gets I have to say that every time I have called BCBS, I have always spoken to the nicest people. Probably just jinxed myself:)

I had to do the 6 month supervised. I am staying with that even though my appointments are over. I only lost about 20lbs, but want to at least lose a few more.

I have BCBS of IL (I'm in VA). My paperwork was just turned in last Tuesday and of course I havent heard anything, but will be calling again Monday. I see you already have a date, which is great. My surgeon won't give dates until the approval come through which is really frustrating because I wanted to have it done this year due to finances and work.

:purplebananna: AWESOME! :purplebananna:

Happy Thanksgiving!!

I have BCBS-IL. I first discovered my surgical group through the insurance website. They were listed as a "blue distinction" center so I figured, I couldn't go wrong with that choice. The requirements for me were: 6 month supervised diet with my pcp documentation from pcp that my bmi was 40 or 35 with weight related health issues Letter of recommendation from my pcp physiological examination (about an hour\30 or so easy questions) All of this was submitted to the surgical group this week by the pcp and submitted to insurance by the surgical group this week. Waiting..

I have finally started posting after lurking for almost a year! I have learned so much. In that time I have completed my 6th month supervised diet, all tests, visits, etc. Called my surgeons office last week to let them know my PCP was sending all the paperwork over and to expect it, so they could submit to insurance. They told me at that point they were completely booked till February. I was really upset as I had been trying to work with them and my PCP to squeeze this in this year. First reason is my work has a "lock down" period at the end of December into January, so my leaving at that time would be manageable when I returned to work. Second reason is that I have met almost all of my out of pocket expenses for this year with BCBS-IL and would have to pay next to nothing. Otherwise, it this doesn't happen till next year, I will have to pay a big chunk. I do believe this is worth any amount of money, but it just seems like that would be throwing money away because my surgeon is booked. I have spoken to his once for the consultation, but other than that, I don't see what other obligation I have to him. Question: If his office submits to insurance for approval, does that mean I have to have him do the surgery or is that approval good for any surgeon? I'm really thinking about contacting another surgeon as there are other "high profile" surgeons in the area. Just not sure why I feel so guilty about reaching out to another when I've only just spoken to him once.

Last chance- Thanks for the input and you are right, it certainly can't hurt. BCBS also told me yesterday that if they put a date on the predetermination form, it may get approved sooner because they are supposed to look at those first. I have just never been the "squeaky wheel", but I'm going to start.

Oh and Monty, I am going to call the original surgeons office tomorrow and plead my case again with the coordinator. I doubt they would let me talk to the surgeon directly since I don't have anything scheduled, but I may ask anyway. All I can do is irritate them:)

Thanks, I don't feel so bad now.I called BCBS and they said that when they approve it, it can be used at any surgeon in the network. I checked the next hospital that is a "Blue Distinction" Bariatric Center in the network. (Which is what I meant by "High Profile", I just couldn't remember what it was called at the time Unfortunately,they are booked as well. Tomorrow I will go further out and try the next one.

I also am in the same kind of situation. My work has a "lock-down" at the second half of December. Plus, to date, I have met just about all of my out of pocket expense with BCBSIL, so having the surgery this year would be the best financially as well. I have just completed my last 6 month supervised visit and my PCP sent the paperwork over to the surgeon's office yesterday. So I will have to follow up to see when they send it in to insurance, but BCBSIL told me the approval time was 7-14 days. When I talked to the the surgeon's office, they said they were booked till February. But would consider putting me on a waiting list of cancellations.(how many cancellations could they have ). I have considered checking other surgeons in the area, but I wonder if this surgeons office gets the approval, does that mean that approval is only good for that surgeon?