Waiting for authorization, on pins and needles

[teambarbie 14]

I spent a few hours last night reviewing this topic and now have doubts and worries and all kinds of swirly thoughts and potential dread!

The practice said they don't submit anything they think has a chance to be refused, I hope their right.

Here is what I know, 6 month diet done, bmi 39, sleep test resulting in a positive diagnosis for sleep apnea, GP recommendation, psych eval - was all good enough for them to submit.

The insurance is Anthem BCBS out of TN, seeing other's anthem experiences it seems a little all over the place, so I don't really know what to think. The insurance company said its under nurse review and they have 15 days to render a decision.

If anyone has experience with Anthem in TN, I would love to hear!

Thanks

[2Big2Skate 328]

It sucks having your future in the hands of some faceless committee's hands. I feel your pain. I was naseous during the wait. Then when I got my approval, I was naseous again for a different reason!

Exercise your right to call in and check on the process (to insurance). I checked every 48 hours.

[teambarbie 14]

It sucks having your future in the hands of some faceless committee's hands. I feel your pain. I was naseous during the wait. Then when I got my approval' date=' I was naseous again for a different reason! Exercise your right to call in and check on the process (to insurance). I checked every 48 hours.[/quote']

Actually, that is what I realized from looking at this forum, that I can have direct conversation with insurance, and will. Thanks!

[teambarbie 14]

I taking your advice, I called Anthem. They said:

-request is still in nurse review

-there is no notes from nurse (then commented that that was a good sign)

-there was no records attached to my request. She said that May or may not mean anything, the nurse reviewing the case may not have attached but suggested I contact the office and let them know.

I contacted the office, the re-faxed everything over. Hopefully, that wasn't needed.

Still on pins and needles!

[Alysha23 31]

You are not alone! I'm waiting on United Healthcare. My paperwork was submitted on the 14th of October. I'm trying not to blow up my coordinators phone. (She is a very sweet and caring lady) Same here, nothing yet: ( They have 15 days, which puts me at November 4th. But I need to know already! Praying for patience.

[teambarbie 14]

Keep me posted, my fingers are crossed for you!

[Alysha23 31]

Thanks and likewise! Did they give you a CPAP machine for your sleep apnea? I was diagnosed with sleep apnea in February and have a CPAP machine. I'm hating it. A lot of people say that I'll get use to it, but no. Don't get me wrong, I'm thankful for it. I didn't have any other health issues besides being obese and borderline diabetic. With my BMI and sleep apnea UHC will cover my VSG 100%. Thank the lord for little miracles. But the waiting is exhausting. Every time I get an email on my phone I'm hoping its my coordinator. Maybe tomorrow!

[teambarbie 14]

They want me to come back in for another sleep test using a cpap and then I guess we go from there. I haven't made it back yet because my husband is on tour and won't be home until 11/11 and I have an eight year old son. I did try the machine for a little while and I have my concerns. I have horrible allergies that have messed up my sinuses, I am often congested and sleep with my mouth open, and as you know, if you are wearing the thing and open your mouth and it feels like your brain is going to be sucked out! My dad recently got one and says it is actually great but takes a whirl to get used to. The sleep doc also said it will really help directly after surgery.

[teambarbie 14]

Oh and my bmi is 39, so I am not at my insurance's auto approve. My surgeon suggested I get the test as a positive result would greatly improve the chances of insurance approving me. Still waiting.........

[Alysha23 31]

"Brains being sucked out" LOL! How appropriate for today. Yeah, I can't wear mine when my sinuses are acting up. I understand the hubby being gone. My husband works on the railroad. US railroad wives call ourselves single moms with benefits. How many more days do you have to go? UHC policy is15 days, I have 4 to go. Sigh: (

[teambarbie 14]

I know what you mean about single mom, though secretly it is probably what makes our marriage work!

Anthem is 15 days too, don't know if that includes weekends or not, but if we must just look at business days, I suppose I should hear by next Friday. I am driving the poor woman at the doctors office nuts - but at least I do it all via email.

[Katcloudshepherd 630]

I'm waiting on an answer from my insurance also. Humana PPO Federal. My surgeon's office submitted my paper work last week, (October 23) and they have 30 days to reply. I've never prayed so hard in my life. I want this so BADLY so I can start the long journey to LIVING a healthier life.

Sending positive thoughts to y'all---I hope we all recieve a yes answer.

[teambarbie 14]

Well, here's wishing all of us a speedy answer! I bugged the poor woman at the doctor's office enough she decided to call the nurse assigned to the case directly. She left her a message and said she'd let me know.

I'm really trying to get this done before the end of the year. Our insurance is supposed to change and I've already met my annual deductable (which is insanely high) so it would be very helpful to get an answer! The surgeon did say that if we can get the approval, he'd do what he can to get me on the schedule.

[amduc 20]

I spent a few hours last night reviewing this topic and now have doubts and worries and all kinds of swirly thoughts and potential dread!

The practice said they don't submit anything they think has a chance to be refused' date=' I hope their right.

Here is what I know, 6 month diet done, bmi 39, sleep test resulting in a positive diagnosis for sleep apnea, GP recommendation, psych eval - was all good enough for them to submit.

The insurance is Anthem BCBS out of TN, seeing other's anthem experiences it seems a little all over the place, so I don't really know what to think. The insurance company said its under nurse review and they have 15 days to render a decision.

If anyone has experience with Anthem in TN, I would love to hear!

Thanks[/quote']

I don't have anthem but I'm in the same boat as you- did the 6 month hoop jumping and bariatric review board was yesterday, should be submitted today. It's easy to get freaked out since everyone's requirements are SO different isn't it? hang in there!

[Alysha23 31]

Oh my, I didn't even think about the end of the year and the holiday's. I'll be putting out some prayers that we all get squeezed in before the doctors take off to the Islands. Well ladies, what are we going to do over the weekend to keep our minds off of this? For me it'll be trying not to stress eat. Monday will be my 15th business day. I can literally hear the clock....tick tock tick tock:)