FEPBlue Approval: How long?

[Flippista 67]

I haven't seen this topic recently. Anybody recently approved? If so, how long did it take after paperwork submission?

Thanks in advance!

[Mandat89 28]

im waiting for a response from them too

[BackAgain 9]

I was recently approved on my second submission for converting Lap Band to RNY.

My first submission was in December. It took about 5 days for the denial. However, I was provided a specific list of why it was denied: No evidence of compliance for previous surgery (lap band), no evidence to support that I did not use nicotine, and no documentation from my family doctor stating that he had not treated me for substance abuse in the previous 2 years (it may have only been previous year, I dont have my records in front of me).

To address these requirements:

1. My surgeons office prepared a memo outlining my history of coming in for band follow up appoints. Many fills and then un-fills due to GERD, etc.

2. My family doctor prepared the required substance abuse letter.

3. I had to have blood drawn for a nicotine test. This part caused the longest delay, since the hospital which drew the blood did not conduct the nicotine test in-house, but had to send it out to LabCorp.

My surgeons office resubmitted my package on 27 Dec and I was approved on Jan 4th.

I hope that helps answer your question.

[Flippista 67]

I was recently approved on my second submission for converting Lap Band to RNY.
My first submission was in December. It took about 5 days for the denial. However, I was provided a specific list of why it was denied: No evidence of compliance for previous surgery (lap band), no evidence to support that I did not use nicotine, and no documentation from my family doctor stating that he had not treated me for substance abuse in the previous 2 years (it may have only been previous year, I dont have my records in front of me).
To address these requirements:
1. My surgeons office prepared a memo outlining my history of coming in for band follow up appoints. Many fills and then un-fills due to GERD, etc.
2. My family doctor prepared the required substance abuse letter.
3. I had to have blood drawn for a nicotine test. This part caused the longest delay, since the hospital which drew the blood did not conduct the nicotine test in-house, but had to send it out to LabCorp.
My surgeons office resubmitted my package on 27 Dec and I was approved on Jan 4th.
I hope that helps answer your question.

Thanks! I have my surgery date planned in April but it would be nice to know ASAP for peace of mind. I appreciate the info!

[Ca Bibliophile 4]

My paperwork was submitted 2/28/17, I was approved 3/2/17 and surgery is 3/13/17.

[Mandat89 28]

Submitted feb 22 approved march 7

[1234567890 328]

It all depends of your medical insurance.. Example, my insurance required 6 months dieting plan, after that I did medical clearance, once all paper work was submitted, took about a week to get approved... probably less,

[BackAgain 9]

Hey guys, just got my EOBs for the surgery and hospital stay afterwards. I thought fellow FEPBlue or Federal BC/BS members might be interested:

1. Two night stay in the hospital after surgery. Of note, the hospital is a BC/BS Bariatric Center of Excellence. My total copay was $350. The hospital requested $175 upfront and advised they would bill or refund once the EOB came in... so I guess they will be hitting me up for some more cash lol.

2. Copay to Surgeon was $200. I had a lap band removal and then RNY during same surgery. Each procedure was listed as a separate line item, but only the band removal listed a copay.

3. There was no copay for anesthesia services.

All in all it looks my my total out of pocket for the two procedures (performed same day) is $550.

[Flippista 67]

On March 20, 2017 at 11:43 AM, BackAgain said:

Hey guys, just got my EOBs for the surgery and hospital stay afterwards. I thought fellow FEPBlue or Federal BC/BS members might be interested:

1. Two night stay in the hospital after surgery. Of note, the hospital is a BC/BS Bariatric Center of Excellence. My total copay was $350. The hospital requested $175 upfront and advised they would bill or refund once the EOB came in... so I guess they will be hitting me up for some more cash lol.

2. Copay to Surgeon was $200. I had a lap band removal and then RNY during same surgery. Each procedure was listed as a separate line item, but only the band removal listed a copay.

3. There was no copay for anesthesia services.

All in all it looks my my total out of pocket for the two procedures (performed same day) is $550.

Thanks!

[Flippista 67]

I received my approval. Timeline as follows:

Feb 22 Submitted to Insurance

Mar 9 Denied; stated that my mental health assessment was not completed by a licensed professional

Mar 9 Letter of reconsideration sent along with mental health provider's credentials

Mar 16 Approved! Previous denial overturned!

Surgery scheduled for April 10!

[BackAgain 9]

I received my approval. Timeline as follows:

Feb 22 Submitted to Insurance
Mar 9 Denied; stated that my mental health assessment was not completed by a licensed professional
Mar 9 Letter of reconsideration sent along with mental health provider's credentials
Mar 16 Approved! Previous denial overturned!

Surgery scheduled for April 10!

Awesome! Good luck to you!

[Keenikwe 82]

I have BCBS FEP... just waiting for my doc to submit. They said they'd do it this week... but i called insurance customer service and they said they haven't received the submission yet...

[CurvyCakes 269]

I was approved in 1 day. My surgeons office contacted me the following day to provide the great news.

[CurvyCakes 269]

@Flippistaomg I'm 4/11 congrats to you!!! When do you start liquid diet? I'm starting 4/4. Not looking forward to it at all.....

[HERnewlife 4]

Submitted feb 22 approved march 7

Which insurance? I have uhc .. just got submitted for approval