How long did your process take to get approval?

[Tory09 1]

:redface:Hi Everyone,

Just wondering what the general concensus is on after you did all of your appointments - how long it took for them to submit to insurance and how long insurance took for approval. I finished all my prereq appointments on Friday. I wonder if I should call my surgeons office on Monday and ask them how long will it take to gather the whole package and send to the insurance...

I have Anthem BCBS PPO and I live in Virginia. I am so nervous - I need your prayers!

Thanks for reading!!!!!!!!!!!

[Jodi11 0]

I have BCBS PPO and live in PA. I went to my PCP in May and he went back 2 visits. That specific visit was #3. I had to have 6 visits total. I went in June and then met with my surgeon and he needed some bloodwork. I had a PCP visit in July and I had my last PCP visit on August 3rd (Monday) and they had already had the approval over the phone by Wednesday. i had my pre-op appt on Friday and surgery is Monday. I met with the required dietician, psychologist, and exercise girl all in one day in July. I am a teacher, so they did all that they could to get me in before school starts. My insurance had a nurse call me and ask me some questions and give me some advice for after the surgery (walking around to prevent clots, etc). She was very nice. I am ready to go. BCBS is a pretty great insurance you just have to make sure that your employer covers the surgery code. You need to call yourself. Ask your doc what the code is. Once you know if it's covered, you shouldn't have any problems if they say yes. Not sure how it varies state-to-state though.

Jodi

[48Cyns 0]

It used to take about 30-days to get your approval back, but for some reason everyone I hear from says they get their approval back in 2-3 days, a week at the most. I started my process on May 5th and surgery is scheduled for August 24th. I elected for the 90-day surgical prep course instead of the 6-months with a dietician. When I went in I expected to have surgery in November, so August was a real surprise!

[Tory09 1]

I have BCBS PPO and live in PA. I went to my PCP in May and he went back 2 visits. That specific visit was #3. I had to have 6 visits total. I went in June and then met with my surgeon and he needed some bloodwork. I had a PCP visit in July and I had my last PCP visit on August 3rd (Monday) and they had already had the approval over the phone by Wednesday. i had my pre-op appt on Friday and surgery is Monday. I met with the required dietician, psychologist, and exercise girl all in one day in July. I am a teacher, so they did all that they could to get me in before school starts. My insurance had a nurse call me and ask me some questions and give me some advice for after the surgery (walking around to prevent clots, etc). She was very nice. I am ready to go. BCBS is a pretty great insurance you just have to make sure that your employer covers the surgery code. You need to call yourself. Ask your doc what the code is. Once you know if it's covered, you shouldn't have any problems if they say yes. Not sure how it varies state-to-state though.

Jodi

Thanks for the info. Yes I already called my insurance company before I started all of the medical appts and they said they did cover weight loss surgery and to include lapband. My husband works for a large company and they even have a dedicated call number just for the employees and their families. They said all I need to do is have it preauthorized/preapproved just like I would if I had any other surgery. Keep your fingers crossed for me as I am so nervous about the approval.

[Tory09 1]

It used to take about 30-days to get your approval back, but for some reason everyone I hear from says they get their approval back in 2-3 days, a week at the most. I started my process on May 5th and surgery is scheduled for August 24th. I elected for the 90-day surgical prep course instead of the 6-months with a dietician. When I went in I expected to have surgery in November, so August was a real surprise! :cool:

Thanks for responding... That would be positively great if the insurance company approved me within a week or so... I am hoping I would be scheduled for surgery in September... if I am approved...

Thanks!

[Froggie D 1]

I have BC/BS insurance. I started my process in January and the end of May I was through with all the requirements. I called for an appt with the surgeon and could not be seen until July 16. That day the surgeon told me they would send in the report within a week. Today is 24 days later and they still have not sent in the paperwork. I have talked to BC/BS and they called the surgeon and were told it will take another week! :cool: I do not understand the delay. It is really frustrating.

Trying to be patient.:tongue:

[Tory09 1]

Froggie, I understand how frustrating it can be! I saw the surgeon first and then did all of my appts. He wanted me to get blood work done too and also a sleep apnea test. I never heard back from anyone on either thing. I wish they wouldnt make you go thru so many hoops. That sleep test was HORRIBLE and the technician said i dont have sleep apnea. I hate this waiting game. It is hard to not worry about everything... I am just doing my best to wait things out and pray about it.... Keep me posted! Good luck !!!!!!!!!!!

[Mia26 0]

I began my 6 month class in Feb. Submitted to insurance July 24th (Surgeon's office was suppose to submit on July 16th!) I did have to call my insurance company every other day. BC/BS of Maryland state it could take upto 2 weeks and that's just as long as they took for me!

I have a feeling that if I had not followed up with insurance as much as I did, I would still be waiting! They actually tried to tell me to wait until next Wednesday but I said they gave me a deadline and they had to stick to it, Friday was the 14th day and I needed an answer!

My advice, get a timeline and force both surgeon and insurance to stick to it! GOOD LUCK!!!

[Gwenbreaz 0]

I have United Health Care HRA in Georgia and it take 6 months for approval. But, worth it!

[nkara 0]

I work for the hospital where the doctor works and performs the surgery. They submitted the insurance approval first and I got approved in about 2 weeks. Now I'm just going for all my appointments.

[Tory09 1]

You are super lucky and very fortunate. I wonder why my dr office doesnt submit for approval before hand? I guess they want to know if you have any comorbidities before submitting to insurance... since that would make it easier to get approval... Good luck to yoU!

[southerngal75 0]

I have aetna open access, anyone know how long they usually take?

[SoAnnaBanana 1]

The more I read the more fortunate I realize I am. I have BCBS PPO of MI and I did not need pre-authorization, just some paperwork filled out. I went to my seminar on June 22 and got my surgery date on August 3rd. I needed to have my Psych eval, a surgical clearance filled out by my PCP, and a letter of support from my PCP. I didn't have to do any diet. My PCP did make it as hard on me as she possibly could though... she made me have a full physical plus some extras, refered me to a cardiologist (I don't have a heart condition) who sent me for a stress test plus extras. All and all I think I had about 20 doctor appointments but I was extremely determined. I have my pre-op bloodwork and nutrtition class August 24th and then off to the OR on September 2nd. Stay possitive and keep your eye on the prize. I remember thinking it was too much work but I never let that get me down. I had first thought I wouldn't be able to have surgery until Nov or Dec so I am so pleased I was able to get everything done so quickly. I had many highs and lows (at one point my PCP would not fill out the letter of support because of "legal" issues"). I went back to her 6 times before the whole thing was settled. Eventually my surgeon just signed off on my form and said it was "semantics".

Good luck!

[Twnkl2os 0]

My first appointment was 04/08/09 and I recieved my surgery date on 08/03/09. I have BXBS PPO,it only took a little longer because I work in a hospital and opted to schedule all the testing there. My surgeon preferred me to use his shrink in the city but I was able to schedule the rest on my own. All my physician was waiting on was the clearance from the shrink. I had my date three days after the shrink eval was in. I actually did my sleep study last night, which was a complete mess. I looked like an alien with all those leads drooping from my head! It was very hard to sleep and they wake you up at the crack of dawn! I guess it really depends on your insurance company. some require you to wait at least 6 months. Good luck!

[isaviolinist 11]

I have BCBS. I finished all my pre-op tests and I think it only took a day or so to get approved.

A lot of you are saying that your surgeon's office staff are not sending in your paperwork and not getting back to you about things. If it were me, I would find another surgeon. My surgeon's office sent all of my paper work in promptly, without any reminding on my part. There was even a pre-op test that was unnecessarily ordered by another physician in the hospital, which ended up costing me extra money and my surgeon himself called me about it to tell me he was going to call the billing office to try and get it sorted out. Everyone should remember: they work for you.