While I wait for approval or not...

[wvgal33 0]

Hello,

I am starting to get ancy about whether I am going to be covered or not. My "things" were turned in to my insurance company on 9/15...and now I wait for their answer. Does anyone have BC/BS PPO? I don't know ANYTHING about insurances...what does the PPO stand for? My husband works for Toyota if that helps. If anyone has the same insurance, can you tell me what experience you have had with them? and how long do they make you wait? What is the longest anyone has ever waited for approval....i want this YESTERDAY! When I first started this journey...friggin 8 almost 9 months ago...I called my insurance company and they said that my policy did not require a 6-month supervised diet. HOWEVER, the surgeon said that he has never ran across an insurance company that gave approval w/o the 6-month diet. Soo.....I pouted...but went to the doc for 6 months and FINALLY...here I am.:confused:

[PATCHELTON 0]

I don't have BC PPO(stands for Preferred Provider Organization) but I do have Blue Choice (in Maryland it is Carefirst Blue Choice). Once my 6 month supervised diet was done and all appts and tests, it was submitted to insurance. They took 4 weeks to approve. I called them once and the service rep told me I would probably be denied because I had used an out of network psych evaluator and dietician (I used everyone at my surgeon's office). They accept WW, Nutrisystem and such, why would a dietician I pay out of pocket be rejected? He was sure I would be denied and have to do the 6 month diet again. I called the surgeon's office, while having a meltdown over this, and they had been trying to reach me to tell me I had been approved! Out of network just means out of pocket, insurance doesn't cover it. So if you are anxious, I would recommend calling the surgeon's office. The insurance reps don't always know what they are talking about.

[justmel1957 1]

I have Federal BCBS. It did NOT require a 6 mo diet. Once my paperowrk was submitted I was approved in about 21 days. (My company has 31 days to give an approval or denial once they receive the submission)

[DanaM 0]

I have BCBS PPO and my hubby works for Honda. I had to do the 6 month diet and sleep study and cant remember what else but once I was finished and paperwork turned in the was approved in about 1 week and so was my hubby! If I was you I would call the doctors office and ask them have they heard anything from ins. company yet because they are busy and they will call you when they get a chance and that is not soon enough for me. They are use to people calling them asking them that question.

[CarolGrant 0]

I have BC/BS and after 6 months of meeting w/ nutritionist and meeting w/ the doc on monthly appts., mine was turned into insurance and was approved 5 days later.

[Mrsace13 0]

I was told with B/C B/S PPO that I would have to do the 6 months. At the seminar they gave us a list of insurances and what insurance required what. Most needed the 6 months except United Health Care and B/C B/S PPO Federal. I can change to United in Jan. but they are one of the few that require a 40 BMI no matter what and I'm a 38 with medical conditions.

[*slim* 2]

Hi. I have BCBSIL PPO. It took about a week for me to get my approval once the paperwork was submitted. I called and emailed the insurance company everyday once the paperwork had been submitted. Usually you can go onto BCBS's website and send a message to customer service or call the number on the back of your card. It doesn't hurt to call the insurance company yourself so that they know that you are very interested in the outcome. Good luck to you!

[ccarter8219 0]

PPO does stand for preferred provider organization, and I believe it depends on which state your BC/BS is a member of to which guideline is utilized. Each state has their own guideline.

I work for the BC/BS of GA which is called Wellpoint, and it includes several of the states such as CA, NY, VA, OH, NC. I think there are more, but I cannot remember all of them. We are combining to an enterprise wide name of Anthem Blue Cross.

Most states follow the 30-31 day rule for an answer to be completed on a request for precertification/prior approval/pre-determination. However it may be delayed if they ask the provider to submit additional information.

Hope this helps.

[illinoishusker 0]

I agree with going to their website or calling. They actually called my dr's office before I got the letter.lol

I have BCBS IL (PPO). It took a week and a halfish to tell me.