Waiting Game......

[Bj49 13]

All testing completed, now just holding my breath for insurance approval. I'm at the lower scale of obesity at 35 BMI. Hopefully, they see all the health issues that I have and realize that this is a needed procedure for me. This is a way for me to be able to get healthy and add years to my life. I would love to see my grand-babies grow up.

[starfishwish 129]

I have my last weigh in today. I'll be given a tentative date pending ins approval. I am BMI 38 with several "comorbidities"

[dmvladybug 6]

My BMI is 39 and I'm wait to be approved too.

[az062217vsg 40]

My BMI is 38. Just submitted to insurance today! Good luck all!

[sprysmeow 28]

Hi, I am in the same boat, my BMI is 36.8, with 3 comorbitities. but I am at the very beginning of the journey. It has taken so long for me to finally decide that this is what I want, I would like for it to just move along quickly. I have my first appointment on Wednesday.

How long did it take to get through the required appointments, before actually having it submitted to insurance?

[Bj49 13]

43 minutes ago, sprysmeow said:

Hi, I am in the same boat, my BMI is 36.8, with 3 comorbitities. but I am at the very beginning of the journey. It has taken so long for me to finally decide that this is what I want, I would like for it to just move along quickly. I have my first appointment on Wednesday.

How long did it take to get through the required appointments, before actually having it submitted to insurance?

I had been doing diets forever and prescription meds for the last 3 years. IT had been suggested by my physician 3 times over the last 4 years before I decided to go to the information meeting. I went to that in February. I met with the surgeon beginning of March. Finished going to the doctors and testing last week. so about 2 months which is what they say it usually takes. But my surgeon just had surgery will not be performing any again until May 22nd. Just hoping for insurance approval.

[Bj49 13]

The waiting game continues.... my insurance company has had my information for two weeks now. The waiting is the worst.

[MSinger 348]

Check in with your insurance company. I'm not sure if this varies from state to state, but for IL there is a 15 calendar day time frame for the insurance company to respond. My paperwork was sitting with insurance doing nothing for an entire week because the first page of the fax was cut off in transmission. Not sure how that happens, but I had to twist so many arms to get my review done.

[Bj49 13]

So I called today to see what was going on. I had to call while working. The person who answered said that it was denied due to insurance not covering the procedure. Which I know is not true because it is listed in my benefit book. I had to talk to three people before they actually looked at my personal benefits when I decided to pursue this procedure. She told me that she would put a note on my file, but I guess she did not. So now I have left phone messages and emails. I guess it is still the waiting game.

[MSinger 348]

Hang in there and ask for a supervisor when you speak with someone next. Sometimes the people quoting benefits mess up. They don't always know how to read the technical jargonish benefit plan language. There should be a specialist who is familiar with the benefits of your specific plan, so keep climbing the customer service ladder until you get confirmation of what your benefits are.

Good luck!

ETA: Also, ask for an Explanation of Benefits letter (EOB letter) to be mailed out to you.

Edited May 17, 2017 by MSinger

[ColleenErin1974 195]

So I called today to see what was going on. I had to call while working. The person who answered said that it was denied due to insurance not covering the procedure. Which I know is not true because it is listed in my benefit book. I had to talk to three people before they actually looked at my personal benefits when I decided to pursue this procedure. She told me that she would put a note on my file, but I guess she did not. So now I have left phone messages and emails. I guess it is still the waiting game.

I was in a similar situation like yours. I was done with my prerequisites 2/23/17 and I just got my surgery date a week and a half ago. It took my surgeon 4 weeks just to medically clear me. I called once to three times a week to keep them working on it for me. Almost 4 weeks later, calls to the office manager, calls to the doctors secretary, and finally after getting the run around I called my insurance company. At this point I was told by my doctors office that we were waiting on my insurance approval for the past 4 weeks, but that was a lie. I called my insurance to see if my approval was pending. I was then told that my policy does NOT require prior approval and that my doctor was notified of this about 3 weeks ago!
Needless to say it was a painful 4 months!
I won't bore you with every detail.
My experience is that you need to stay on top of this and call both your doctors office and insurance to make sure someone doesn't drop the ball.
I'm now scheduled for June 21st, after the marathon my dr made me run!
Remember that your doctor works for you and you are your own advocate for your health care. Keep calling!
Take care and good luck with your surgery!

[Bj49 13]

Well after going back and forth with my insurance company after they denied it at first, I was called today from my insurance advocate who says I have been accepted. Yes, finally I am on my way. Excited about leaving some of my medical problems behind with the meds that go with them. Now just waiting for my date.

[Bj49 13]

Finally I have my date. August 15 will be my sleeve day. I start my two week diet for liver shrinking on the 2nd. In one month I too will be sitting on the losers bench.

[angel78357 6]

Last Thursday was my last nutrition class.. They were going to send in my paperwork to the insurance company for approval... I have a BMI of 37 with 3 pre-excisting conditions. I am excited, nervous and scared!!

[mbchinadoll88 1]

Check in with your insurance company. I'm not sure if this varies from state to state, but for IL there is a 15 calendar day time frame for the insurance company to respond. My paperwork was sitting with insurance doing nothing for an entire week because the first page of the fax was cut off in transmission. Not sure how that happens, but I had to twist so many arms to get my review done.

I'm glad to know about the 15 day rule. I'm in Illinois and I still have a few appointments so I haven't s gotten that far yet