Submit to insurance Day 1 of coverage?

[brownbeauty 0]

I went through the Pre-op process with the surgeon that I would like to do my lap band surgery about 4 months ago. Back when I had United Health, the surgeon's practice was not IN Network so they did not submit to insurance. I have since changed coverage (my husband got a new job). March 1 we will have Blue Cross Blue Shield, who is contracted with my surgeon's practice. The insurance department has seen 100s of surgeries approved with Blue Cross Blue Shield. I am so very anxious to have the surgery done, I would like to submit the claim for the Lap Band March 1, the day coverage starts./ Do you think that is a good idea? I am pretty sure I will be approved, my BMI is 44. The policy states that obesity surgery isn't covered unless it is deemed to be "medically necessary" - which mine is, I am 28 with HBP and Morbidly OBESE.

Please advise as to what I should do. Do I wait it out or submit right away?:smile2:

Thanks!

Brown Beauty ♥

[Elisabethsew 50]

You're paying to be covered by this insurance company as of 3/1 so you're entitled to benefits. I would call them and ask for a written list of what they require to pay for the surgery. It's better to know before hand so you can check them off as they get done. Welcome and congratulations!

[Thin4Anisha 0]

I will be doing the same thing. I (for various reasons) did not sign up with my companies health insurance during open enrollment. Now that I have decided to have the band I find out my other insurance, through my parents, does not cover the procedure but the insurance my company offered does. I will sign up with the company during this years open enrollment and on 1/1/09 I will submit the paperwork.

Good luck to you and please keep us posted on the companies response!

[NicoleW8ing 0]

I went through the Pre-op process with the surgeon that I would like to do my lap band surgery about 4 months ago. Back when I had United Health, the surgeon's practice was not IN Network so they did not submit to insurance. I have since changed coverage (my husband got a new job). March 1 we will have Blue Cross Blue Shield, who is contracted with my surgeon's practice. The insurance department has seen 100s of surgeries approved with Blue Cross Blue Shield. I am so very anxious to have the surgery done, I would like to submit the claim for the Lap Band March 1, the day coverage starts./ Do you think that is a good idea? I am pretty sure I will be approved, my BMI is 44. The policy states that obesity surgery isn't covered unless it is deemed to be "medically necessary" - which mine is, I am 28 with HBP and Morbidly OBESE.

Please advise as to what I should do. Do I wait it out or submit right away?:thumbup:

Thanks!

Brown Beauty ♥

Check on Blue Cross's requirements in your states for pre-op. If you don't have all the i's dotted and t's crossed, they'll deny you. Just go over it thoroughly and make sure you have everything, and I don't see why you shouldn't submit it on Day 1.

For me, BCBS required a 5 year CONSECUTIVE weight history.