If you Live in FL but have out of state Insurance....

I need your help!!! My story is way too long to go into.  My question is.... If you live in FL but have out of state Insurance, does your surgeon have to submit to FL? For example, I live in FL, but through my employer, my insurance is BCBS of Michigan.  We have submitted a request for pre-authorization to both MI and FL and have yet to get a response.  How long do they have to come back with a response?

Check your policy.  In some cases there is specific language that determines the timeline in other cases there are state mandated time frames.  I am by far not an insurance expert but I am thinking whatever it is in Michigan may determine your coverage. Red

Hey Tralynn I am in your exact same situation, I live in FL but have BCBS of Mi...you can read my blog for more info. on what I've gone through with the company. Basically they do NOT require preauthorization so the first time you submit they will not answer you. The first time I submitted I waited 36 days before I found this out. They want you to basically have the surgery and hope that they pay for it afterwards. You really have to talk to the insurance person at your surgeon's office and get them to call provider inquiry...be very stern and say that your surgeon requires preauthorization. Then they will give you an address and a sentence that has to be in the first line of the letter that your surgeon sends to them. Without this line, BCBSM will not even look at it. Also they will not provide you anything in writing about the requirements because we're out of state. I posted on the Michigan board when I first started this and everybody loves this insurance there because they dont have to wait for preauthorization. Its a different story here because no doctor is going to perform this surgery without knowing that they will definitely get paid. I wish you luck. I have been waiting since March for an answer. I just called today and found out that they FINALLY came to a decision after 4 submissions. However they won't tell me what it is and I can't get in touch with the insurance person at my surgeon's so I'm still waiting.  Good luck to you!! Have faith...it'll happen.

Our insurance department at US Bariatric Orlando just discovered a few tricks when working with BCBS of Michigan. We just got a patient approved by submitting to MI. Response time varies with company, but generally 30 days.

HTH.