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Insurance Approval Timeline

I am still waiting. They said they were sending over the paperwork 4/28 but still have yet too. So I am so nervous I am going to be denied. :( I know things are backed up due to Covid. They said I would receive something in the mail from the insurance company or a phone call from the surgeons office.
 
canecorso81 said:
I am still waiting. They said they were sending over the paperwork 4/28 but still have yet too. So I am so nervous I am going to be denied. :( I know things are backed up due to Covid. They said I would receive something in the mail from the insurance company or a phone call from the surgeons office.
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Are you are you phoning the office? I would phone the office once a day everyday and I would say "I am really afraid I'm going to be denied and that is why I am bugging you. Please please please let me know if I have been approved for the surgery."

Actually I would make a friend of someone in Billing or reception and I would say "Listen you know I really don't want to bug you. I'm just really afraid. Have other people been calling with the same questions?"

calling the office too much is really a positive sign that you're motivated to have surgery. They are used to people calling in with needs and wants. They're even used to people who call in because they're afraid their insurance won't cover. In any event you should talk to them. And you should call them everyday and if they don't know today say "okay well I'm going to call tomorrow and see, okay? "

you have the right and the responsibility to phone a medical provider in order to find out if you are going to receive a service. Doctors are not God although some like to think so. And the people on the front lines doing the paperwork don't mind hearing from you as long as you're really nice about it.

I was I was recently signed up for the city's Senior Services, although I didn't even know the age of 6 this is it until I got the call. My case managers name is Janelle and I said "Listen Janelle, I know you probably have a lot of clients. I would like to discuss the aspects of this with you but please don't overload yourself on my account. Just let me know when we have time to talk. " I gave her a few suggestions of things that I need it and she said she would start working on them. She appreciated that so much and two weeks later she called to update me and make an appointment for us to talk. She wanted to talk to me because I was nice to her. She may have dreaded talking to somebody else who had a lot of problems and was taking them out on her, which is very likely. Senior citizens have a lot of ageism stacked against them.

Just call and be nice. You will be remembered for that.
 
Well the appointment was interesting. My doctor took 20 minutes to talk about the politics behind the covid. Then when we finally start talking about my surgery he basically went over the risks involved (which were very scary). He let me know he is excited to do my surgery as he feels it will really benefit my health issues. Then he tells me I'll hear from someone in 2 days to schedule my surgery that insurance approved it after they denied it and wanted me to lose 3 pounds, which he said the office took care of that and they then approved it. I asked oh, it was approved?? I havent heard anything . He went to check with the office lady and came back in and said I apologize, that was for the patient after you!!!!
Then the lady tells me they tried to send the paperwork and insurance company's arent accepting prior authorizations until June 12!!! I'm so frustrated and ready to give up.
So I left that appointment still waiting for an answer if I even can get approved for this.
 
BCBS denied my gastric bypass, then they denied my appeal. I am a cash pay patient for this surgery, so that shows how serious I am about making a positive change in my life. The money I am spending for the surgery would have bought a lot of donuts, pizza, pasta, and slider food! lol
 
LDM said:
BCBS denied my gastric bypass, then they denied my appeal. I am a cash pay patient for this surgery, so that shows how serious I am about making a positive change in my life. The money I am spending for the surgery would have bought a lot of donuts, pizza, pasta, and slider food! lol
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I love your determination but is there any way you can keep appealing? I'd hate for you to have to pay out of pocket for something proven to be medically necessary. Obviously, I don't know your weight and weight-related health issues but sheesh, it's so uncommon to be completely denied these days.
 
LDM said:
BCBS denied my gastric bypass, then they denied my appeal. I am a cash pay patient for this surgery, so that shows how serious I am about making a positive change in my life. The money I am spending for the surgery would have bought a lot of donuts, pizza, pasta, and slider food! lol
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Wow really! That makes me upset at insurance! Why on earth were you denied twice??
I know it's a lot of money to pay personally but the determination shows and you will do great!
 
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