any info on approval time needed

hello I am new to this site  I m trying to find out what to expect as far as approval time I have blue cross blue shield of Illinois and my dr just submitted today for the lap band how long does it usually take for an answer   is it true you are usually denied at first? help im driving myself nuts

Each situation is unique.  It is true that most insurance companies will deny first requests.  This is mainly because the insurance companies are playing the odd's that companies typically change carriers every two years.  So if they can put off approval, there's a good chance that you will end up leaving before they have to pay out $30,000 to $70,000!  In addition, they still view WLS as elective surgery for those who are too undisciplined to diet and excersize to loose their weight.  Never mind that there are many many studies that show huge savings in medical costs through WLS.  So many insurance companies will make you do 6 month or 1 year supervised dieting, or classes or some other form of delayed testing in hopes that you will simply go away.  I had a friend who was 200 pounds overweight and had been for over 40 years.  He had been through every kind of diet program there was.  He was practically a poster child for WLS.  After two years of denials, he hired a lawyer and took the insurance company to court.  The judge was amazed at the insurance companies lawyers, because they had no defense!  They simply kept trying to delay the process in hopes of him going to a new insurance company!  They even tried to get the case continued with no explination.  The judge found in my friends favor.  He is now 2 years post op and at goal weight!  He's lost 206 pounds and is doing great.  My best advice is to give them everything they ask for, keep copies of all corespondence, and work with your surgeons office very closely (they know how to deal with this type of stuff).  I've heard many stories of quick approval.  The good news is that as you progress towards the surgery, you will be learning how to adjust to the mental side of WLS, and most of us found that pounds started coming off even before we had our surgeries.  As I was told before I had my surgery, it took a life time to get to this point, it will take a bit of time to get to your goals!  Good luck, and keep checking in.  We're a fun group!

Hi Kristie!
Welcome to the Illinois board!  We are a pertty friendly and supportive bunch.

I have BCBS of IL PPO.  On first submission with them, they stated that I did not have the (at that time) 1 year supervised diet.  Although my doctors pleaded with them that I have been dieting steadily for over 15 years, they still wanted it done THEIR way.  So, I began seeing my doctor once a month, every month and kept great notes.  About 9 months into it, I learned that they had changed to a 6 month supervised diet.  I gathered my records and sent them to the lady whose name was on the original denial.  She called me just under a week later to tell me of my approval.

That is my experience.

Now, your experience may vary, but if you have completed ALL of their requirements then you should hear something within 2 weeks, but they have 30 days to respond.  Some of the people here had no trouble at all and were approved on the first try, and some others had to fight tooth and nail.  I guess it just depends on where the file lands and if the reviewer is in a good mood that day.

Please TRY not to drive yourself crazy over it (although I KNOW how hard that is...) and think of other things or get involved in something to keep your mind off of it.

I am crossing my fingers for you and wishing you good luck!

I have BCBS IL PPO and I was approved within 2 1/2 weeks the first time!  Everyone is different.  Hang in there and after about a week give the insurance a call and stay on top of it!

Good luck and don't forget to check in with the daily roll call. We're a friendly bunch here! 

We sent in my paperwork after I only completed 5 months of the supervised wl program. They replied within one week that I had to complete an additional month. I did, my surgeon's office faxed that add'l documentation to them and I received my approval 3 business days later... I called every day to check the status. I was nice and I talked to several nice reps too. I don't know if that helped or not, but my surgeon's office said it probably did. Good luck. I hope you get a very quick approval!!!!

Amy