One step back

[crissyboo 63]

Today was supposed to be a joyish day for me, but instead it turned out to be filled with stress and sadness. Today was my last appointment before all my medical information can be sent to my insurance company for approval. Unfourtenaly things didn't go as planned. So a couple of months ago I had insurance through my employer and BCBS FEP became my secondary insurance. Well, I no longer have that insurance and it was terminated July 31st when I left the company.

So since then I have been going to the doctors and realized that my claims were being denied because BCBS stated that I still had another insurance plan. So I called a couple of weeks to get this issue resolved. Fast forward today while I was walking to my car after the appointment it dawned on me that BCBS was still denying my claims after I called to informed them that I no longer have that plan. I called once I got in the car because something told me this might be an issue and I need them to get the ball rolling. So I call today thinking that this would be something they could do instantly or maybe like a day or two. The rep told me no it takes about 3-5 days for their system to update. I am scheduled for surgery on the 13th. That means BCBS will only have about 3-5 to approve my cause if not less than that. This really sucks. I thought everything was moving in the right direction now I am stumped. Has anyone else dealt with this issue before?

[LisaMergs 2,854]

Well, the GOOD NEWS is that BCBS typically approves the day after they receive the file. As long as your team submitted- and all requirements were met-you should be cleared right away! Find out when they sent over the info, wait two days and call the ins company. You mast be pleasantly surprised! Then, if they approved you, call your team and tell them. Usually the wait comes on their end anticipating a physical confirmation in the mail. One call from the ins coordinator to BCBS and you should be good to go!!

(Note- this was my experience as well as a few others on here I know of and I can't promise the same results. Just want to give you the info I have. Call and follow up!!!)

Good luck!

Sent from my iPhone using the BariatricPal App

[crissyboo 63]

@@LisaMergs I don't think that they submitted the information because the coordinator called to try and get an authorization, but I am assuming was unable to do so because she called me to inform me of what was going on, which in turned made me call my insurance company once more. I don't think she was able to get an authorization done at this point.

[Djmohr 6,965]

@@crissyboo

My surgery was approved hours after they had it in hand. Same insurance, just push your doctors office to get it in there quickly.

Best of luck!

[crissyboo 63]

@@Djmohr I am hoping that once they clear up the information with the other insurance it won't take long for them to approve it! Thank you guys for your feedback and support. I'm feeling somewhat better about everything.

Sent from my iPhone using the BariatricPal App

[crissyboo 63]

@Djmohr, I called my insurance company this morning to follow up on the request. The rep that I spoke with told me that my file has been updated and there shouldn't be a problem with my doctors office submitting the authorization. After I hung with her I called my doctors office to inform them and I was so happy when the receptionist told me that my authorization was already submitted yesterday. Here I am working myself up. Finger crossed I get an approval within next week.

[crissyboo 63]

So I am officially approved for September 13th. I just received the phone call from my Surgeon office.