BCBSGA HMO--2nd denial today

Ok, I received my 2nd denial letter today from BCBS of GA(HMO) and I was expecting them to say that "it was not medically necessary", but instead they said that they could not overturn the original denial because they never received any information from the surgeon. Im so mad right now. Ive waited since January 23 and called them everday. And they always tell me the same thing---"its still in review" "it was just sent out to external review" I get different answers every time I call. And now I just got the 2nd denial because they have no information from the doctor. Has anyone else ever had this happen? Are they just stalling? Im at a loss for help. Any advice would be greatly appreciated.

I also had BCBSGA HMO and I had no problems... I owe mine to my surgeons office they did everything for me... sounds like you need to get with your surgeons office... the lady at mine said it was best with them to send everything they require the first time... I was told that in oct 2003 that they started making you see a nutritionist before surgery... Good luck in your process!! Wished I could be of more help...

I HAVE BSBCGA HMO. I HAVE BEEN WORKING ON THIS FOR SO LONG !! I STARTED OVER 2 YEARS AGO !! I HAD STATE MERIT INS. PPO , I WENT TO SEVERAL MEETINGS ,THEN OUT MY PPO DIDN'T PAY ( OR SO THEY SAID ) I'VE READ ON HERE THAT THEY DO PAY . ( I WORK IN A SCHOOL ) SO WHEN WE HAD OPEN ENROLLMENT I CHANGE TO BCBS HMO . DR. DAN PROCTOR IN GAINSVILLE WILL BE MY SURGEON IF I EVER GET SURGERY. I WENT IN SEPT TO THE WEEKEND WORK SHOP AND DONE EVERYTHING THAT IS REQUIRED TO GET THE SURGERY , I'VE SPENT OVER A THOUSAND DOLLARS OUT OF MY POCKET, THAT I WON'T GET BACK ! ALL MY STUFF WAS SENT IN DEC. 18,2003. ON DEC. 31 THEY SAID THEY THE LETTER FROM MY PCP DIDN'T HAVE SURGERICAL CLEARANCE ON IT. I WENT TO GAINSVILLE (25 MILES AWAY ) AND GOT MY PCP TO PUT THAT ON THE LETTER AND CARRIED IT TO DR. PROCPTOR' S OFFICE , THEY HAVE FAXED IT 3 TIMES AND IT GETS LOST. I HAVE FRIEND THAT HAS HAD HER STUFF LOST 4 TIMES . I'M SO TIRED OF THIS , BUT I'M NOT GIVING UP. JUDY

Next time you call the insurance ask them to speak to their supervisior that talking with them nothing seems to get done or answered. They never know what the other person is doing so they make up excuses. I had to fax some stuff and stood there and did it 3 times in a row and called them and they claimed they didn't get it... Sometimes they just deny stuff the 2nd time because it was the 1st and never really looked into it.... If you go through the supervisor part it should go faster.. Hope this will help .... Call first thing and find out exactly what was missing for it to be denied so you can correct it...You know that there was info from your dr. on there other than that how else would you have gotten referred... Laura