Horizon Blue Cross Blue Shield NJ Experiences?

[LumpySpacePrincess 594]

Anyone have any experience with submitting to them, how long it takes to get a response, approval rate? From what I'm finding (and what the insurance coordinator for my surgeon says) they seem to be approving a lot of people very easily right now. All of my pre-op work is done, except the last consult with my surgeon before surgery and setting a date.

Let me know if you have any experience with them!

[JerseyGirl68 1,172]

Hi There,

I also have HBCBS NJ. I was sleeved last December. Last summer they required a 6 month supervised diet, but right when I started my process, they did away with that requirement. They submitted on a Thursday and I believe it was just a week until I found out I was approved for surgery. Very smooth process with the insurance. I went out of Valley Hospital and the coordinator was very knowledgeable of the system. I don't know percentages, but if you meet the criteria and have all the docs in place you should be golden. After they submit, give it a few days then you can log into your account online and see if it has gone through the system yet. Or give them a call.

Best of luck!!

[Tikvah 70]

Jersey, do you remember what docs and info were submitted to horizon bcbs? I have them as well.

[LumpySpacePrincess 594]

Hi There,

I also have HBCBS NJ. I was sleeved last December. Last summer they required a 6 month supervised diet, but right when I started my process, they did away with that requirement. They submitted on a Thursday and I believe it was just a week until I found out I was approved for surgery. Very smooth process with the insurance. I went out of Valley Hospital and the coordinator was very knowledgeable of the system. I don't know percentages, but if you meet the criteria and have all the docs in place you should be golden. After they submit, give it a few days then you can log into your account online and see if it has gone through the system yet. Or give them a call.

Best of luck!!

Thank you, Jersey! That's interesting because I am also going through Valley (Dr. Bagloo)! What did you think of the actual procedure with them? How was the hospital itself? I know at Holy Name Hospital they have individual monitors where you can go online and watch tv to be "entertained" while you wait or to distract yourself. Anything like that at Valley? I know I probably won't care when I'm all doped up, but these things cross my mind! Please share your Valley experience!!

[JerseyGirl68 1,172]

Jersey, do you remember what docs and info were submitted to horizon bcbs? I have them as well.

I had to submit a letter stating why I wanted the surgery and detailing my past weight loss efforts. It included a "weight" history from my primary doc. They really just wanted to see that this was a long term problem I guess. There was testing required: EKG, Endoscopy, bloodwork. But nothing too out of the ordinary.

[JerseyGirl68 1,172]

Thank you, Jersey! That's interesting because I am also going through Valley (Dr. Bagloo)! What did you think of the actual procedure with them? How was the hospital itself? I know at Holy Name Hospital they have individual monitors where you can go online and watch tv to be "entertained" while you wait or to distract yourself. Anything like that at Valley? I know I probably won't care when I'm all doped up, but these things cross my mind! Please share your Valley experience!!

My surgeon is in the same practice with Dr. Bagloo, and I have heard nothing but good things about her. My surgeon was Dr. Schrope. I was completely impressed with Valley. The care was fantastic. The surgical waiting room was comfortable with individual televisions and I could have someone there waiting with me until they brought me in. They were very attentive, and kept bringing me warm blakents. Internet connection was spotty in that waiting area. But other areas it was fine. Unless this has changed, all surgical patients had a private room, which was nice. I did not have to ask for a single thing while I was there. The day I had my surgery there were quite a few of us recovering from sleeve surgery. The floor itself was quiet and I got plenty of rest.

They don't wake you in the middle of the night like some hospitals, unless you have special or unusual needs, they will round before you go to sleep.

I highly recommend the practice and the hospital to anyone that asks. The followup I have had is great. Everyone there is very helpful. My nutritionist is Meredith Urban. Another rave review from me about her.

When is your surgery??

[LumpySpacePrincess 594]

My surgeon is in the same practice with Dr. Bagloo, and I have heard nothing but good things about her. My surgeon was Dr. Schrope. I was completely impressed with Valley. The care was fantastic. The surgical waiting room was comfortable with individual televisions and I could have someone there waiting with me until they brought me in. They were very attentive, and kept bringing me warm blakents. Internet connection was spotty in that waiting area. But other areas it was fine. Unless this has changed, all surgical patients had a private room, which was nice. I did not have to ask for a single thing while I was there. The day I had my surgery there were quite a few of us recovering from sleeve surgery. The floor itself was quiet and I got plenty of rest.

They don't wake you in the middle of the night like some hospitals, unless you have special or unusual needs, they will round before you go to sleep.

I highly recommend the practice and the hospital to anyone that asks. The followup I have had is great. Everyone there is very helpful. My nutritionist is Meredith Urban. Another rave review from me about her.

When is your surgery??

No surgery date yet. Waiting on the insurance approval, and the packet went out this morning! I love Meredith! Such an easy going nutritionist; her plan is so easy to follow!

Thanks for the info on the hospital! Sounds really fantastic and I'm happy I chose Valley!!

[Phillys1stlady 32]

Anyone have any experience with submitting to them' date=' how long it takes to get a response, approval rate? From what I'm finding (and what the insurance coordinator for my surgeon says) they seem to be approving a lot of people very easily right now. All of my pre-op work is done, except the last consult with my surgeon before surgery and setting a date. Let me know if you have any experience with them![/quote']

Mine took 24 hrs...but my friends took 3 days

[LumpySpacePrincess 594]

The waiting kills me. I keep checking my Horizon online account every few hours to see if anything has come in! lol Going to be a long weekend if I don't hear anything by tomorrow!

[Phillys1stlady 32]

The waiting kills me. I keep checking my Horizon online account every few hours to see if anything has come in! lol Going to be a long weekend if I don't hear anything by tomorrow!

Have you called them? I called and received the news that way

[LumpySpacePrincess 594]

Have you called them? I called and received the news that way

No, I'll probably wait until tomorrow afternoon to call since everything was just sent in at 9am this morning. I know the squeaky wheel gets the grease but I'm almost afraid if I call they'll deny me for being annoying. haha

[mazzers120 75]

No' date=' I'll probably wait until tomorrow afternoon to call since everything was just sent in at 9am this morning. I know the squeaky wheel gets the grease but I'm almost afraid if I call they'll deny me for being annoying. haha[/quote']

I know I was thinking that too, lol.

[Phillys1stlady 32]

No' date=' I'll probably wait until tomorrow afternoon to call since everything was just sent in at 9am this morning. I know the squeaky wheel gets the grease but I'm almost afraid if I call they'll deny me for being annoying. haha[/quote']

Although, I received the verbal approval...I just received the letter 3 days later...hopefully, if you call today they will have an answer

[LumpySpacePrincess 594]

Called and they told me they couldn't give me an answer over the phone and that "it may take up to 30 calendar days to process this request." I don't think it will take that long, but the waiting is excruciating!

[Phillys1stlady 32]

Called and they told me they couldn't give me an answer over the phone and that "it may take up to 30 calendar days to process this request." I don't think it will take that long' date=' but the waiting is excruciating! [/quote']

I hope u get an answer soon...I'm getting sleeved in 2 weeks on 11/4...so once you have it everything will move quickly