Shanni1269

How do you get on an EXPEDITED case?

It seems like they have your life in their hands and they aren't as anxious to get this done as we are. This is why I like the doctors that give a tentative date once everything is complete (pending insurance approval), instead of waiting until after approval to start scheduling. Not that I have that kind of doctor....but I wish I did.

I know they want all the requirements completed so they can submit to insurance with the best possible outcome....however, I do not have faith that this particular person will be putting in much effort on my account Sent from my SM-N920P using the BariatricPal App

Well...suprise she called me this morning and was rude it took all I had to ask my questions. So they wont submit to insurance until ALL requirements are met even though 4 of the 6 requirements are surgeon requirements not insurance requirements. whatever...im sure she will mess up my insurance submission just to keep me from getting my surgery even longer. Its sad that I feel that way towards what should be a medical professional. Maybe its time to switch...I dont need to fell uneasy for such a big decision I am making in my life..and I already have to fight insurance...I shouldnt have to fight dr office too Sent from my SM-N920P using the BariatricPal App

O my insurance called me and they have (at my request) tried to call the coordinator at the surgeons office over 10 time and left messages to get her the updated insurance requirements for Surgery. They said they have NEVER returned their calls. She hasn't returned any of mine either. Today I faxed some of my documents over to her and requested she call me ASAP. It seems my options are deal with her... Change surgeons (and offices)... file a grievance... What do you all think I should do???

If I didn't have to use insurance I wouldn't jump thru all these hoops. I have contemplated self-pay, but my husband says "we have insurance and we are going to use it".

So the insurance coordinator finally received the right information regarding my insurance but now says they are going to use the recommended 3 months from initial consultation before sending approval anyways. The surgeon said NOTHING about that. He said if my insurance didn't require weight checks I could be ready in a matter of a couple months. I think she is punishing me for knowing more about my own insurance than she did and I was persistent in getting the information to her. I need to call the office to clarify but I am so angry I am afraid I am going to say something that will just piss her off and she will prolong my process even more. I really like this surgeon but do not know if I can deal with this person.

i tried...waiting to hear back Sent from my SM-N920P using the BariatricPal App

I have Dietician Tuesday and Psych Thusday...then Endoscopy and hopefully insurance approval.... Sent from my SM-N920P using the BariatricPal App

i had all my stuff printed out and prepared as well. I just found out I dont have the 6 month requirement. (although i have done 2 of the 6) Sent from my SM-N920P using the BariatricPal App

East Bay here..... Sent from my SM-N920P using the BariatricPal App

I have gotten confirmation from my insurance that the 6 months is no longer required, but the Surgery Coordinator will not listen to a word I say or even look at the policy from my insurance that I printed out and brought with me to the appointment. I am not trying to tell her she is wrong, just that she doesn't have the most updated information for MY insurance...she is one of those types that doesn't like to be wrong. Like I couldn't possibly know anything about the subject or done any research on my own behalf...like someone couldn't know more than her about MY insurance. Problem is I rely like this surgeon and don't want to upset her because she has my scheduling in her hands..lol. Now a rep from my insurance is trying to get ahold of her to confirm and until then I keep doing my pre-op instructions. I have NUT Tuesday, Psych Thursday and an appointment with my gastro doctor the following Monday (still need to schedule the Endoscopy after that). Then that's it...they wont schedule me to do insurance approval because Coordinator is instant that I need 6 months. I have 2 months and still have the next 4 on the schedule...but I REALLY just want to submit to insurance. Wish me luck

Well how did the appointment go?

My surgeon requires psych, 1 NUT and and endoscopy.

https://www.blueshieldca.com/provider/content_assets/documents/download/public/bscpolicy/Bariatric_Surgery.pdf Here is the link of the policy my insurance gave me

I just spoke to probably the most helpful person at Blue Shield and no..it is no longer a requirement. It is up to the discretion of the patient and the provider