Medically necessity letter for BCBS

[VSG148Sz6 68]

Well, my Dr. Just completed my "medical necessity" letter. My surgeon is ready to submit on Monday so prayerfully it doesn't take too long. Can't wait for my approval because surgery is scheduled for March 27.

[alisha510 20]

Oh good luck! Hopefully it sails smooth..

Did you had to write the letter or your doc wrote it?

How many pages was it? Just curious, I found out today that my doc went for maternity leave and i.don't know who will be writing my letter, kind of nervous about that..and if they do write, will they do a good job?

Keep us posted!

By the way 27th is my birthday so double good luck to you!

Alisha

[Luvlvnlyfe5 48]

Good luck! My surgeon won't give me a date until I'm approved. I'm still waiting ....

[Bebee 33]

Oh good luck! Hopefully it sails smooth..

Did you had to write the letter or your doc wrote it?

How many pages was it? Just curious' date=' I found out today that my doc went for maternity leave and i.don't know who will be writing my letter, kind of nervous about that..and if they do write, will they do a good job?

Keep us posted!

By the way 27th is my birthday so double good luck to you!

Alisha[/quote']

The nurse n my dr office wrote my letter!!

[VSG148Sz6 68]

The nurse n my dr office wrote my letter!!

Thanks a lot guys, but I was rejected by the ins comp again. They said I could appeal but I've been on this journey a full yr now since I found out something was wrong with my band. Since having it removed I've gained all the weight back and these ins comp want to play with my life. I've already scheduled to have surgery in MX on March 22. As God would have it it's even earlier than when my NJ surgeon could have done it. I truly can wait. I'm not apprehensive about having surgery abroad because there are great doctors all over this world. Can't wait to start my new life....I'll keep you posted

[VSG148Sz6 68]

Good luck with your approvals...I pray it works out better for you guys

[beby241977 12]

i just got a letter today from the doctors office saying "your insurance has notified us of an authorization for your prodedure on 3/27/13, this authorization is based on medical necessity and not a guarantee payment . What is that suppose to mean? Is that what you got, i also have BCBS

[VSG148Sz6 68]

i just got a letter today from the doctors office saying "your insurance has notified us of an authorization for your prodedure on 3/27/13' date=' this authorization is based on medical necessity and not a guarantee payment . What is that suppose to mean? Is that what you got, i also have BCBS[/quote']

It's probably meant to address the fact that your dr requested pre authorization. With that, the insurance company is letting you know they agree that your procedure is "medically necessary." In order to get the payment letter you would have to have the procedure then they hour pay....BUT with all that said nothing beats picking up the phone, calling the ins comp directly and asking for an explanation.

[makemyownluck 785]

i just got a letter today from the doctors office saying "your insurance has notified us of an authorization for your prodedure on 3/27/13, this authorization is based on medical necessity and not a guarantee payment . What is that suppose to mean? Is that what you got, i also have BCBS

This letter is saying you're approved.

They have to put in the "this is not a guarantee of payment" part to cover their butts in case 1) your insurance lapses between now and when you have the procedure or 2) they are billed for something other than what they've approved (as in, your MD requested approval for sleeve and instead they do a mini-bypass or something that's investigational and not covered). It's just technical mumbo jumbo, but in short, it's saying that they agree that your surgery is medically necessary. Which means YOU'RE APPROVED! Congrats!