Insurance Approval Jitters

[biglady904 65]

Me too! My case is in the hands of AETNA & the grace of God. One day at a time.

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I'm with Aetna as well

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[Shrinkinqtpi 202]

They told me I should know if I need another dietitian appointment by the 11th of July. It is progress and my surgeon is incredibly supportive. It is going to happen in the "right" time. As a junior high school teacher, it would be great if surgery happens in July but I'll take what I can get.

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[AmberMc03 59]

I have Aetna as well. The surgeons insurance coordinator screwed up and didn't submit when I completed all the requirements so when they finally submitted I called Aetna and explained the mix up and that I really needed to schedule ASAP because my kids are with their grandmother for a month and I wanted to be done and back before they get back. They marked it urgent and it was approved the same day! Then it took another almost 1 week before they called me to schedule. I was very disappointed to have to push my surgery back 2 weeks. I will only be about 4 days post when my kids come home..... But they know what's going on.

[doingitmyway 87]

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[Kyn13 215]

It's really good to have yall to keep up with and check in on:) helps make this wait a little better !

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[biglady904 65]

It's really good to have yall to keep up with and check in on:) helps make this wait a little better !

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I feel so relieved as well to have people to talk to. My family knows I'm doing this but in a way I feel alone with this if that makes any sense

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[Kyn13 215]

It's really good to have yall to keep up with and check in on:) helps make this wait a little better !

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I feel so relieved as well to have people to talk to. My family knows I'm doing this but in a way I feel alone with this if that makes any sense

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Yes I know how you feel I'm pretty sure my family wishes I would shut up already lol here lately it's been all that's on my mind

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[donya4859 28]

@@Kyn13 thanks and I'll keep my fingers crossed for you.

[Shrinkinqtpi 202]

I will call as soon as I can to speed things along. Hopefully they can lock me in as well.

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[kmorri 1,689]

You are all right the waiting for the insurance approval I think was the worst part of the whole thing.....I think it's because you've done all this hard work and jumped through all these hoops and this last thing could just put an end to it all....

As someone who just recently gone through it, let me just say it is all worth it in the end! and once you get past this the next thing you'll be waiting for is getting a surgery date...haha Once you get the date it starts to get real real fast!!!

As far as the insurance approval don't be afraid to call customer service and check on the status of your auth. Wait until it's been submitted for a week.....5 working days and then call to check to make sure they have it and what's the status....from that point call every other day.

I retired from Florida Blue (BCBS of Florida) I think one of you has insurance through them. Back in April when my auth was done they had a 6 business day back log (I found that out through inside connections) so that means about 6 days before it gets to someone's desk to review.........it is probably still about the same, so hang in there!

If anyone gets denied ask your surgeon to request a Peer to Peer review....that's when your surgeon will argue your case with a doctor who works for the insurance company.....most of the time your surgeon will win.....if he doesn't then you or the surgeon can request an official appeal.

I wish all of you the best of luck! You'll get past this stage in no time!!!

[Kyn13 215]

You are all right the waiting for the insurance approval I think was the worst part of the whole thing.....I think it's because you've done all this hard work and jumped through all these hoops and this last thing could just put an end to it all....

As someone who just recently gone through it, let me just say it is all worth it in the end! and once you get past this the next thing you'll be waiting for is getting a surgery date...haha Once you get the date it starts to get real real fast!!!

As far as the insurance approval don't be afraid to call customer service and check on the status of your auth. Wait until it's been submitted for a week.....5 working days and then call to check to make sure they have it and what's the status....from that point call every other day.

I retired from Florida Blue (BCBS of Florida) I think one of you has insurance through them. Back in April when my auth was done they had a 6 business day back log (I found that out through inside connections) so that means about 6 days before it gets to someone's desk to review.........it is probably still about the same, so hang in there!

If anyone gets denied ask your surgeon to request a Peer to Peer review....that's when your surgeon will argue your case with a doctor who works for the insurance company.....most of the time your surgeon will win.....if he doesn't then you or the surgeon can request an official appeal.

I wish all of you the best of luck! You'll get past this stage in no time!!!

Soo good to hear all this from an insider!!! Thanks for all the good info!!!

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[doingitmyway 87]

Has it been your experience that Florida Blue approves those who meet criteria if they submit the documentation. Over 35 BMI with hypertension

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[kmorri 1,689]

@@doingitmyway If your BMI is over 35 but under 40 it really depends on the seriousness of the hypertension......sometimes if it's controlled with one medication it's not approved......if you have to take more than one medication it's more likely to be approved............Is hypertension the only obesity related condition you have?.....If it's denied try not to worry too much....ask your surgeon to do a peer to peer review.....he obviously thinks you need to surgery, so he can argue your case with a Florida Blue doctor and may be able to get it approved for you.

Wishing you the best of luck!

Kathy

Edited June 27, 2016 by kmorri

[Kyn13 215]

Omg it's finally a week day, this weekend has drag painfully by for me, will be calling the surgeons office today to see if they got my paper worn and to hopefully set up my appointment. Who else is calling and checking in on ppl today???

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[biglady904 65]

Omg it's finally a week day, this weekend has drag painfully by for me, will be calling the surgeons office today to see if they got my paper worn and to hopefully set up my appointment. Who else is calling and checking in on ppl today???

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Lol. I'm so happy it's Monday I will be calling and checking today

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