need advice

[Mcrutchky 30]

I am new on here. I have BCBS fed'l standard (85%/15%). I went to my intake appointment 8 business days ago. My question? How many of you contacted your insurance to find out if the submission has been received/approved? How long did you wait? I Should get approval with a BMI of 45.5 but Who knows.

[debpaige 35]

Yes you will.. I did I had a bmi of 36 and I also had sleep apnea high blood peer sure high cholesterol .... I got banded weighing 190 5/2. ..... So my goal is 125 ... I'm down 18 pounds in since my surgery 6/11/2913....

[Mcrutchky 30]

Did you call your insurance or wait it out?

My PCP wrote a letter citing my knee pain, joint pain and GERD.

[melissag43 51]

go ahead and call. I had a 6 month period where i was supposed to see my regular about weight loss. My insurance required it. Between me and the nurse at my surgeons office we got my insurance to approve me ahead of time. My last reg dr visit should have been July 22nd. Instead I'm having surgery July 10th and cannot wait. Good luck.

[lisacaron 5,075]

I think it's worth it to call your insurance company and find out what the requirements are for them to approve. There are different standards and requirements for different companies and types of coverage. Some want a 6 month supervised diet and testing for co-morbidity's done prior to approval and some don't require anything more than the Dr. referral and a certain BMI. Calling and checking on what your insurance company wants helps you be more in the driver's seat to get where you want to go.

Through my whole process, I kept tabs on the Dr.'s, the testing and the insurance companies. I fast tracked the things I was able to, and asked for copies of all the test and clearance letters to send to the surgeons office so I did not have to wait for the Dr.'s offices to mail out letters or get around to sending the fax on my behalf. That helped to keep things moving, and gave me a back up incase the insurance company or the surgeon's office or the hospital was missing anything.

[aufan 69]

I have BCBS Federal too. Certainly call if u have questions about your claim. I had to complete 3 months dr supervised diet, psych consult, physical therapy consult an nutrition class. After all that was complete my WLS doctors office submitted my package and two weeks later I received a letter approval. I'm 3 months post op and I've only had to pay for my portion of the copays. BCBS will tell you what you need and the doc office should tell you your costs.

We have GREAT insurance as far as WLS goes!

Wishing you the best!!!

Sent from my iPhone using LapBandTalk

[Cwalband 215]

I went ahead and kept in contact with my insurance as often as I felt the need, just to ensure they were gettig all my paperwork etc. Granted I tend to be a little impatient and anxious all the time, but after I submitted my paperwork and finished all my requirements from the insurance it took them 9 days to come back with a response.. they told me it would take anywhere from 30-60 days so of course to my surprise I had the go ahead in a little over a week. My nurse said it depends on who is working your case and how many cases they are working on. I hope you get a response soon! Me nagging them all the time could have been a reason why they approved me so quickly, so I say go for it! haha best wishes! xx

[lisamase 52]

My dr office was cool and told me to call, think I called a week or so later and it was approved. Got approval number and gave to office. Good luck!

[Mcrutchky 30]

I called everyone. the doctor's office sent my packet for approval on 6/21. the insurance told me the nurse has it for review. they said they have a turn around time of 15 days! Excited, scared and still waiting!

[BayougirlMrsS 3,934]

my doctors office submitted everything as a packet with a surgery date.... i was approved within a few days..

But, keep in touch with insurance... it's what you pay them for...