question

I submitted my paperwork to insurance and QUICKLY got a letter stating they needed additional info. My surgeons office sent them a not so nice letter along w/another copy of their med policy stating all the info was there and she highlighted, circled and arrowed the info and re-faxed. I just called again (as I have been every morning since she re-faxed it) and everymorning I usually get the "it is sill in review" quote. This morning the gilr said it has went to the next step to the doctor to review and that it was a good thing. She said it is not definite yet..but usually a nurse reveiewer reviews it first and if it does not meet the criteria or needs add'tl info ..the nurse reviewer sends the denial letter. She said if everything is in line then it goes on to the dr. for final decision. But the dr. has to make the final decision. Anyone familar with this? (plus just found out yesterday starting 01/01/07 that my company will have an exclusion for WLS. BUT if you already have you p/w in before then they will honor it) Tracy M.

Hi Tracy - It sounds like things are moving in the right direction. It will all work out. Just keep plugging along and get all of your required testing done. Who's your insurance thru? Best of luck to you. Christina

Thanks. My ins co is BCBS of IL, ppo

Just bug the poopy out of them . they will eventually give in...Luckily I had an email addy's to do this....and they finally gave in after all the paperwork was done....twice!