Empire Blue Cross Blue Shield PPO

[theloosinggame 0]

I have Empire BCBS PPO. I went through all of the work up and when my paperwork was submitted the insurance called my MD back and said I did not need pre-approval. I called to get that information myself from them. I guess as long as you meet the guidelines and it is outpatient you do not need pre-approval. I had my band on 2/5 and I have not gotten an EOB yet. Good luck

[theloosinggame 0]

I forgot to add the my surgeon had already sent me for the psych, nutrition ed, etc so they had everything for them to review. I guess he has a standard protocol that he does and it works very well. From start to surgery day was August 07 to Feb 08. It is a long wait, but worth it.

[kaninag 35]

I have been pretty impressed with empireblue. My doctor "waived" the psych eval and less than a week after submitting everything to insurance they said they needed it luckily i was able to get an appt superfast, the psych dr got my letter to them the SAME day that I saw him and I had my approval 4 days later!!! I had surger 1/31 and am doing fab!!

[pippinje 0]

I am currently waiting on my predetermination from Empire BCBS. I spoke with the medical management nurse and she said since the surgeon submitted it as outpatient, then it did not need to be pre-certified but most surgeons want a pre-determination letter stating that they will cover it before they do the surgery. Let's keep our fingers crossed.

[miles2empty 0]

Thanks to everyone for posting their experience with Empire BCBS PPO. I too am currently awaiting approval, although my case manager at BCBS said it's just for the forms to come back and shouldn't be an issue. Had my nutritional, psych and surgeon consult, so hopefully will find out soon. Even had my EGD last week too, so one step closer to the goals!!!

[pippinje 0]

Guess I need to update this huh? I was approved 02-25-08 and my surgery is scheduled for this Friday.

[miles2empty 0]

Wow!! Congrats Pippinje, that is exciting. Are you nervous, excited, scared, all of the above?!? I think I'm aiming for sometime in April, but it can't come soon enough. My 2nd visit with the surgeon is on 3/12. Woohoo!

[pippinje 0]

Excited!!! Definatley excited. Surviving the liquid diet and just anxious to get it over with. Leaving for Dallas today! Wish me luck!

[miles2empty 0]

Woohoo. Let us know how you are doing. I hope all went well!!

[pippinje 0]

The gas has been killing me and I am a little sore. I don't feel much like eating at all, but trying to force myself to get enough liquids in. Other than that....playing the waiting game.

[miles2empty 0]

Pippinje-

Wanted to give you an update, hope you are feeling great. All of my paperwork was submitted to insurance today. Talked to my RN case manager at Empire BCBS, said she'd call me by Wednesday. Keep your fingers crosed for me!!

Thanks!

[kaninag 35]

If the RN doesn't call you wed-CALL her!!

Good luck to ya!!!

I was pretty fortunated with EMpire BCBS bc they told me it would be another 2 weeks or so before they knew anything and the RN called me 3 days later and gave me the news...

[Guest Icymamma]

Yesterday my sister in law said that there was something on the news that medicaid was now going to start covering lap band. I have searched google and fox news ( she said it came from fox news late night edition)...I can't find it for the life of me...

Has anyone heard this yet? If so if you find it can someone post what they said here in a reply.

Thanks

[miles2empty 0]

Try this link

KOMU.com - The Skinny On Bariatric Surgery - Improve Your View

[pippinje 0]

Pippinje-

Wanted to give you an update, hope you are feeling great. All of my paperwork was submitted to insurance today. Talked to my RN case manager at Empire BCBS, said she'd call me by Wednesday. Keep your fingers crosed for me!!

Thanks!

Hope everything goes well. I start ack to work tomorrow. Not excited but you gotta do what you gotta do. Good luck!