Waiting 4 months for Approval

I have BCBS of Texas. My information ws sent to them in early June. BCBS of Texas requested more information (5 year weight history and a history of supervised diets in the past 12 months) all requested information was sent in the last part of June. I am still waiting - I call at least 2 times a week - still no decision made. They keep telling me all information was received and is now in the hands of the determination team. Any suggestions? I have heard that some BCBS Plans will not be covering the Lap Band or Gastric Bypass starting in 2005 unless your company that you are insured with has a rider for those services.

Hi CV, I am the Angel to a wonderful woman in NH that has your very same insurance and she has been fighting the good fight for months now. They continue to deny her even after she submits the required information they request. She has just gotten a lawyer and is taking matters into her own hands, ot the atty's hands, I should say. Keep appealing, keep fighting, and if you want, contact Karen Maria, you can find her as a Peer in NH. Good luck and keep us informed! -Deb

I'm not an insurance expert by any means, but it strikes me that ther should be some time limits in place by law. Can you check with the state gov of TX and see if they require any time limits for insurance company claims? Also, you could look at your benefit book and see what they say is a their proceedure. Four monts is an aweful long time for NO ANSWER whatsoever. At least the other lady was getting an answer (albeit not the answer she wanted) My insurance guideline was 30 days maximum for a response. It was a timeline they set up. Perhaps a call to the ins. co with some anonomus questions are in order...or a call to the insurance commissioner in your state. Good luck Lisa C