Waiting On Anthem Bcbs For Gastric Sleeve Surgery

[Rainsong 12]

Does anyone have Anthem BCBS of CT or from another state? I'm waiting on approval and I swear I'm going to explode if I don't hear an answer soon. I know this is a common feeling for everyone, but how have/did you cope(d) with the wait?

I think I'm going a little crazy because my hubby has been deployed for a long time and is coming home soon which will be a MAJOR adjustment, my mom is coming to spend a week with me, and I'm a music teacher with lots of concerts coming up, not to mention my most important job of being a mom to my six year old. I'm so anxious about everything that I can barely sleep at night which I know is driving ME crazy but I also know my lack of sleep must be driving my daughter and my students crazy as well.

My surgery is set for December 19th. I'll only have to miss one week or so from school.

[indi1 66]

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.

[Rainsong 12]

Good Luck! I'm calling on Monday as well. I think the only reason I have a date is because I wanted the date to be right before Christmas break so I wouldn't miss too much school and because I knew my hubby would be home from deployment before Christmas.

Did you have to do the 3 or 6 month weigh ins?

[indi1 66]

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.

[indi1 66]

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:)

[Rainsong 12]

First of all sorry for all of the confusion regarding your insurance. I actually did not have to do any doctor weigh-ins. I had written up a quite extensive list of my prior weight loss efforts. At one point before I had my daughter I lost just shy of 100 lbs.

I also agree with you about BCBS, everyone that I have spoken too in this entire process has been GREAT! I'm the type of person that if my service is bad, I'll kindly let people know and on the other hand if my service is great, I'll also let them know. I've commented to every person at BCBS how nice they have been!

Good Luck! Let me know how things turn out.

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:)

[indi1 66]

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...