ARRGGGHHH - Insurance delay & question

I called my insurance co (BCBS of NJ) about my hospitalization last week and while I had the gal on the phone I asked about the status of my wls approval. She told me they had sent or were sending a letter asking for more info from the surgeon (she wasn't sure if it had been mailed yet). When I asked why they didn't just call the surgeon's office & ask for the info instead of taking over a week to mail the request I was told that wasn't their procedure. I asked if the info could be FAX'd to them and she said, "No, it probably would have to be mailed back". This will add another week or more for them to get it in their mail room, then who knows how long for them to enter the info as actually being "received". I called the surgeon's office just to give the insurance gal a "heads-up" that this request was on the way. She said they'd never had to provide those kinds of details (describe surgery & length of small bowel reconstruction) for any insurance co. She thanked me for the news and she'd discuss it with the surgeon and have him dictate a response so they can respond as soon as they get the request - another delay while it is being transcribed and mailed back to BCBS. NOW for the question - I was told by BCBS that they had 30 days from the date they "received" the approval request to respond - since they are requesting more info, does the 30 days start over again or do they still have to make a decision by the original date?? OK - I know these things take time but I feel like the ins. co. is just dragging their feet or trying to find a reason to deny my surgery (& so does the surgeon's ins. gal). WHY do they think I'd sign up for life threatening surgery if I didn't really need it, much less that 5 of my doctors would write letters saying it was medically necessary????!!! They just don't get it!!!! Thanks for letting me vent Vickie J.

Hey Vickie, when I appealed(i originally was denied) with Aetna, I mailed everything plus faxed it. They approved based on the fax within a week. Keep strong, it took me 9 months to get approved but once I was I had the surgery a month later. Keep your head up everything will be fine. Hugs, Christine -70

Thanks for the pep talk! I sure hope it doesn't take me that long b/c I've heard that BCBS will NOT cover wls after 12/31/04 but I'll keep at it!! Vickie J.

I know that blue cross, blue shield can be terrible. The denied me and I hired a lawyer, Obesitylaw.com and got an answer in 7 days. I would have never gotten approved if it was not for that firm. But keep fighting it if they do not approve you. Good luck.