Steps the Insurance Companies take to either approve or deny...

[sabrina4you 17]

I would like to know EXACTLY what steps the Insurance company takes once they receive your packet to get approved or denied?...I mean WHAT DO THEY DO? How many people touch the paperwork we send in? Is it one representative that makes the decision or a panel of people? Someone please tell me how this works? I will be submitting my paperwork packet on January 4, 2009…crossing my fingers for a fast approval and fast sx date. J

[btrieger 21]

I think these are questions for your insurance company. I'm sure that they all have their different ways of doing things.

I was told by my surgeons office that Aetna and BCBS usually approve or deny within 3 weeks of submission.

[AZSunshine 0]

My insurance was a self-funded indemnity plan through my dad's work.

They had a list of criteria I had to meet (BMI of 40, 6 month diet, psych test, etc etc).

The way they did it.... my records were all sent to a nurse who reviewed it and determined whether or not my case was "sufficient" to approve.

I was fortunate to get in touch with her directly (I'm obnoxiously persistent).... and she helped answer many of my questions.

I would imagine that your insurance probably has a similar process.... a qualified med professional will probably review your records and determine whether or not you're eligible for coverage.