just starting the process

Hi I am new to this webpage and would like to get all the information i can about the process that i have to go through to get approval.
Is there  anyone who has blue shield  ppo ins that gave give me some information about how long it takes to get approval. I have an appt with the psychologist monday 10/27/08. In november i have appts. with my physician to have an ekg and i'm also going to see the nutritionist. Any and all information would be greatly appreciated. Thanks

Congratulations on your new journey to a healthier you.  I have Anthem Blue Cross PPO, but I believe Blue Shield is similar - my best advice is to contact your insurance plan and ask as many questions as possible. By the time my surgeons office was preparing to submit my paperwork for approval, I was confident I would be approved as I contacted the insurance carrier with each test, every question I could think of to make sure it was covered, and the provider was covered, etc. Sometimes after I would get an answer and I wasn't confident with it, I would just call back - maybe that's why I got approved in 3 days so i would stop calling them . 

Be proactive and stay on top of the process. Make sure the surgeon has all your medical records, make sure the Psych faxes their report asap, same with the Nutritionist.

Good luck and best wishes.

Sue

Hey, NetBrat...Welcome to OH. SOo glad to see you are here. Dr Coates is a great surgeon. You won't see mauch of him but he has a good staff. Just make sure all the paper work is done when you get your date.

HUGS
JOY

I have the letter I used on my page. Wish I had sent it earlier. Feel free to copy it. Send it CERTIFIED mail to your primary care doctor, your group and to your insurance company! It worked for me!

Hi Everyone,
    Thanks for all the helpful information. I can't believe that I was able to get all my appts. scheduled before the end of Nov. Is this normal. Now after I get the psychologist, nutritionist and primary care doctor appts done will they submit my paper work to the insurance company. Dr. Coates already has all my medical records. I've already had my first appt. with the pa at Dr. Coates office and she said that I was a good candidate due to that fact that I am diabetic with traces of protein in my urine and my feet, knees and back hurt all the time. Your right madam joy the office staff is so nice and they made me feel so comfortable. Nascar24n48 I couldn't find the letter that you were talking about I'm not very computer savy sorry. Could you email it to me or point me in the right direction. I should have made this  move along time ago but I was so scared about having surgery. Now it can't come fast enough. I'm 41 years old and I'm ready to live my life to the foolist. I've missed out on so many things that I like to do like go to laguna-seca for the American Lemans race with my husband and walk up to the cork screw. Does it take the insurance long to approve it or do they make you jump through hoops. Thanks again everyone have a good night. Talk to ya soon.

Netbrat (Kristi)
P.S. How long does it take before I can post messages without it going for approval?

 

Hi Everyone,
 
Thanks again for all the helpful info. I have my consult with the Dr. Morgan psychologist monday and he said he would clear me for the surgery. So 1 appointment down and two more to go. I just can't believe it took me this long to make the decision to go for it.  Thanks again everyone. I will keep you all updated.

Netbrat (Kristi)

Hi Kristi!  And Welcome!!!

I have BCBSIL ppo and it took me 10 months from start to finish, but I had a lot of "road blocks" along the way.  Best advice is call your Insurance Company, see what their requirements are and try to jump through every hoop they set out for you the best that you can.

Keep notes on who and whom you speak with and document everything.  Be pro-active in everyway you can.  Have your PCP take good chart notes!!

I wish you the best!

Jeni

Hi there!  Welcome to OH!  I also had Dr. Coates as my surgeon (4 years ago) and Dianne as my PA.  One thing I have learned from listening to everyone's experiences is that there is no "normal" to the process.  Blue Cross/Blue Shield is usually pretty good...but everyone's case is different.  Once I had my first consult with Dr. Coates's office things went pretty fast.  I think my consult was on Aug 1 and surgery was Nov 3.   Now it took me about a year and a half to get to that point due to several reasons mostly insurance related (changes at work).  I am a firm believer that all things happen as they are supposed to so I just let things fall into place and didn't stress about it.  I am coming up on my 4 year anniversay and couldn't be happier with the outcome!  Good luck to you and God Bless!

Hi Nebrat! I also have Blue Shield PPO. THis is what I have learned so far....I had my first appointment with Dr. Coirin on October 3rd, appt. with Psych. on October 6th and my physical with PCP on October 10th.I had already had my appointment with a nutritionist over the summer that counted.  After Sherry, Dr. Coirin's insurance person, recieved all of the information from them she faxed everything to Blue Shield on October 23rd. I have called the insurance every day since then, but still no answer. They have 5 business days from the day they recieve the letter to approve or deny. I should have an answer by Wednesday. I am worried because although severely overweight I dont have any major comorbid conditions. I dont have high blood pressure or high cholestorol, I am not even prediabetic. According to the lady at Blue Shield they review each case differently, so I am just keeping my fingers crossed. You should be fine and everyone keeps telling me Blue Shield is known for approvals. I will let you know more as soon as I know.