Final Weigh-in Before Submitting to Insurance!

[LINZ62383 39]

I have my final weigh-in of my six-month insurance-required monitored diet coming next Monday. Assuming all goes well, which I think it will, they will submit to insurance for approval of the surgery. How long did it take others to get an answer from their insurers? Did anyone call them and try to light a fire under them to get it put through? I have no problem doing that if needed and if it has been successful for others. I am so excited, but I am also nervous I won't know anything for awhile after the surgeon's office submits it for approval.

[TaRena 32]

Insurance has 14 days to respond. Yesterday I learned that on the 14th day they can send a letter extending their time. However, I've read that a lot of people get their answer earlier. I did a search on my insurance company and also asked the question about how long it took others who had my insurance how long it took them. The median answer was a week. Its been a week for me and my pre-cert status is still pending. I started calling 2 days after submission and they told me two bogus things. Typical canned answer plus they gave old info. I have Cigna Open Access Plan and was told they were waiting on clinical notes for 6 months of visits. Cigna now only requires 90 days of supervised visits. This is per their Medical Coverage Policy for Bariatric Surgery effective 6/15/17. But I know its been like this for at least the previous year. My surgeon's office shows they received everything but resent it all again. I know they have 14 days but I'm going to be a squeaky wheel they have to oil every day. Good luck on your journey.

[SweetNTwisted1 0]

The reason they have a 14 day turn around time is because there are potentially 1000's of other cases they are also reviewing and they do them in a first come first serve basis. Asking them to review your case ahead of someone else often does not result in a favorable answer. If you think about it, how would you like it if someone did that to you? If it is not life threatening give them the time they need to the review and not rush through it, possibly missing something and then you not getting the results you want! Good luck!

[Results8567 34]

I have Anthem Highmark PPO and also another Anthem PPO through my husband and I received an answer within 2 days of submittal. It might have come in sooner however, two days after was just from when my bariatric center called me.

[LINZ62383 39]

I have Anthem as well, so hearing you had such a short turn around time gives me hope. It's just been a long six months and I'm ready to have my date set!

[Results8567 34]

I was the same way! Its a long drawn out process. It really messed with my emotions to be honest. My "surgery date" is September 7th. I'm putting "surgery date" in parentheses because at this point I STILL don't feel like this is all real. LOL. Essentially, till I wake up in a recovery room- its not happening. lol.

[LINZ62383 39]

I haven't been too bad emotionally until this last month. I'm ready to have my date set and get things in motion. I don't blame you about not thinking it's real until you wake up in recovery. I'm going to be the same way! Lol