NEED ADVICE!!!!!! BCBS of TN has not replied within 30 days of greivance

[KayKay 0]

:confused2:

I was denied Lap Band surgery and have filed a grievance letter, They wrote back and stated that they had received the grievance letter and would be turned over for review, letter states that case will be reviewed with 30 calender days and with in five working days of review I would revieve a letter upon the determination.

BCBS of TN received grievance letter on March 20, 2008, I have called back constantly everyday, today when I called BCBS of TN the lady stated that the Grievance Department had not made a decision. What?????????

What should I do? They have already had 30days, and nothing has been decided, when I call the department I just get the answering machine or a lady states she will get the message to the department.

I mean this is a life altering decision for me, why should my life be put on hold. I remain very polite to BCBS of TN put my patients are running thin.

Any suggestions?

[SherryW 4]

KayKay...although they told you 30 days are you sure that didn't mean 30 business days? Which for us would be more like 6 weeks not 4 weeks. If it's business days then you're still within their 30 day window. Maybe you want to ask that question of your BCBS rep just to be sure and ease your mind. Also...my surgeon's office actually helped me with that whole process...I called them and they called the insurance carrier when it was past the timeframe we were given that things would be approved. Turned out that for some reason my insurance carrier had me down as a different race than what I am so it threw their test results off somehow? Who knows how but it did and when the docs office corrected them, then my tests were fine and I was approved. Anyway...definately check on if that 30 days meant business day...it usually does.