canecorso81
Member
I have still not heard anything from my Dr office or insurance. I am getting very annoyed but don't want to bother them as I know how backed up they are. Sorry just had to vent. UGH!!!!
Still nothing
- Thread starter canecorso81
- Start date
canecorso81
Member
It has been 3.5 weeks. I still don't even know if insurance approved it.
I haven't even gotten a date yet or started any pre-op. I just did all my 6 month requirements. I just want the Yes answer and ill feel better LOL.
canecorso81
Member
I don't think my office has even sent the information cause my insurance is saying they have yet to receive anything. I just called and left a message so hopefully they will get back to me with good newsMy drs office told me it takes the insurance company 6 weeks to hear if it’s been approved or denied. Now that’s my insurance and drs office, and I’m not sure if they’re all the same. Keep your head up, it’ll happen
dianeseattle
Member
You might think that you are bugging the people in the office by calling. But they might think you don't care because you haven't bothered to call. More times than not, I have been given to understand that follow-up is your responsibility and if you do not show them that you care and that you are committed, they will just put you on a dark shelf somewhere. It's much better to make those phone calls, and keep making them until you get your answer. You have done everything you were supposed to do. You deserve to know what your status is. You don't have to be mean about it and you won't be. You're just being responsible, to them and to yourself.I don't think my office has even sent the information cause my insurance is saying they have yet to receive anything. I just called and left a message so hopefully they will get back to me with good news
My surgeon advised me to give them 2 weeks, and then start calling the insurance company for updates. He stated you have to stay in their face a little to keep things moving along (kind of a "squeaky wheel gets the grease" type of thing). My insurance denied me within 3 weeks and denied the appeal within a week, but at least I had my answer and had to decide if forking out the cash was worth it. In the end, I decided to invest in my health, but hopefully, your insurance company will be better humanitarians than mine.
canecorso81
Member
My insurance, BCBS, doesn't pay for bariatric surgery. I went through all the testing, including the psych eval. The insurance company found that I didn't have any symptoms worrisome enough to pay for the surgery. So I paid out of pocket for it all. They didn't even pay for all the testing. Don't take my experience and worry that the same thing will happen to you. If they deny you, get your surgeon involved.
canecorso81
Member
OH no! I have excellus bcbs blue point. Was your BMI not high enough? I wonder why the office navigator had you go through all the requirements knowing your insurance didn't cover it. I would be so mad. I have paid a lot of money out of pocket so far for all my co pays and psych eval appointments. They made me do 6 sessions of just that. 1 a week.
I am so nervous of that happening to me.
I am so nervous of that happening to me.
dianeseattle
Member
Can you be specific? What exactly were your numbers? A lot of people are overly worried about this but their experience will not be the same as yours. Were you 100 pounds overweight? What your BMI? What comorbidities did you have that were related directly to obesity? What medications were you taking relating to those comorbidities or obesity in general?
There are many differences from doctor to doctor, not just insurance companies. I really would urge everyone not to assume you will not qualify because you have the same insurance company. Approval or denial is a complex issue and often can be successfully challenged.
Other members of this group have BCBS and they have been approved. In fact, in all the time I've been with this group, hardly anyone has been denied. If a person feels sick enough or endangered enough to ask a doctor about it, the doctor generally recommends the patient look into this surgery.
So if you are a person who is thinking about weight loss surgery, do your research so that you are prepared when you talk to your doctor about this. It is a major, life-changing step and doctors are listening to you to hear if you are in enough danger to have this serious alteration of your digestive process. Don't assume that you won't qualify. As long as you're not considering this a cosmetic procedure and you do have comorbidities, it's much more likely you will be approved
I researched the surgery and went to orientations and listen to Medical people explain various procedures for a year or two before finally feeling ready to see a bariatric surgeon. I went without a referral and he wrote a letter on my behalf to my insurance company saying I was 100 pounds overweight and my health was deteriorating because of obesity. Then, before he even sent the letter, he scheduled my next appointment, which was pre-op. The entire process took less than a month and I had surgery scheduled before it was even approved.
Of course, I had my surgery 13 years ago this August and things are different now. But they do not even require that you be a hundred pounds overweight anymore, which was required when I had surgery. And in my state, Medicaid paid 100% at the University of Washington Hospital, but there was a one-year wait. If you wanted it sooner, you had to pay 20% of the cost yourself. I could not afford that as I was on Social Security already. So I filled out forms to get charitable care through the hospital and it was approved. I didn't pay a penny of the cost, including postoperative care.
It's really important to accept that for some people, weight loss is impossible without the assistance of this surgery. People who yo-yo diet and lose 50 lb and gain 100 lb and lose a hundred pounds and gain 150 lb are demonstrating that there is something broken and they need help. I was one of those people. I am so grateful for the technology that offered people like me a way back to health.
Keep your chin up and your eyes on the prize. Have a positive attitude and gather together all the facts. Once you know what you need to know, your doctor will be able to determine that you can make informed consent for this life changing surgery. Don't give up.