Insurance Approval

[Changing2012 7]

About how long does it take the insurance company to approve the lapband surgery? I live in Illinois & have Health Alliance. Its been 3 weeks of waiting already. Once I get the approval I'll be on my way on my new lifestyle journey.

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[NWgirl 574]

Have you called your insurance to inquire as to the status? If not, I would. I read awhile back about a gal who had been waiting for a week or two for a response, only to call either the Dr or the insurance to find the paperwork had not been submitted as promised.

[Changing2012 7]

I called the Dr. they assured me that all papers were submitted & all they are also waiting to hear from my insurance company. I will call the insurance company 1st thing Monday morning because I am ready! Thanks so much for your help!

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[GermaineF 25]

After the first week after dr's office submitted my paperwork, I called my insurance company everyday, sometimes twice a day...no lie...It got to the point that I called so much once they approved me they called to let me know i was approved and that they were going to fax paperwork to my dr...

[emonie71 14]

Question.. I have my initial consult with the surgeon and he says I meet the weight requirement. I have an appointment with the psychologist for my psych eval and an appointment to meet with the nutritionist. When does they paperwork get submitted for authorization?

[Changing2012 7]

Thanks Germaine, I'm definitely calling them 1st thing in the a.m...

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[Changing2012 7]

Emonie, after I saw the nurse & nutritionist, they submitted my papers. My insurance did away with a psych evaluation. Good luck to you!

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[emonie71 14]

@ changing2012 ok thanks I have BCBS federal just wanted to know what time frame I was looking at for approval. Just a little nervous want this so bad you know. I'm 5'2 @ 192 BMI is 35 with hb pressure and now issues with knees because of the extra weight have heard people with BMI less than 40 are hard to get approved.

[GermaineF 25]

@ changing2012 ok thanks I have BCBS federal just wanted to know what time frame I was looking at for approval. Just a little nervous want this so bad you know. I'm 5'2 @ 192 BMI is 35 with hb pressure and now issues with knees because of the extra weight have heard people with BMI less than 40 are hard to get approved.

Emonie, i have BCBS Illinois and my BMI was 35 when I started this journey, and I was approved. I had high blood pressure and was denied 2 weeks after paperwork was sent in, b/c i only had 1 co morbitity. I then had a sleep study done and have sleep apnea Dr resubmitted paperwork and a week later I was approved. But this was after calling everyday bugging the heck out of them. I was in a time crunch b/c i wanted to have surgery before the end of 2011 b/c i had already met my ins. ded and would pay 0 out of pocket. I made it happen and had surgery on 12/16, one week after approval. Yea me....

[emonie71 14]

@germaine thanks so much for the encourgement. Sounds like I should be fine based on what you posted.

[FutureCRNA 3]

I'm in same boat I am 4'10 BMI 41 no comorbidities with BCBS FL. Paperwork to be sent in this week...... I'm so happy, nervous, anxious, ready about being banded. I'm ready to start living again!!!!!!! I will give them 1 week after I know paperwork sent in then I will be calling them daily inquiring on status of application.

[Lady T730 3]

Unfortunately, I was denied and it only took my insurance company a few days to decide. They said I had not been at my highest weight long enough and only had 1 co-morbity. The doctor's office wanted me to go though the appeals process but I didn't feel like waiting so I decided to self-pay. But I look at no news is good news because if they wanted to deny you they could have done that real quick.

[emonie71 14]

@ladyt730... Thanks for your reply back do you have federal bcbs insurance?

[Lady T730 3]

@emonie71, I have federal Aetna. A few of my co-workers have both BCBS and Aetna and had no problems getting approved.

[emonie71 14]

@Lady T730.. Okay thanks the doctors office hasn't submitted my information to insurance yet I think I have to have my psychological evaluation and meet with the nutritionist first? I don't know really that's why I was reaching out on her to see how the process works.