Masshealth/Network Health...Can approval really be so easy?

I am going to my evaluation on the 29th. Before going, I wanted to check with my insurance company and see what the requirements were for getting approved and having the surgery...just in case I had to gather up any documentation or whatever else they needed. So I called in spoke to a rep at Network Health. She told me all I needed was a letter of medical necessity from the doctor. Thats it.....no other requirements at all. I asked how long the approval process usually took. She said I would be approved within 48 hours of them receiving the letter. So according to her as long as the doctor says he'll do it ...I'll be approved. I thought there would be some long review process or something. So many people seem to have approval issues with their insurance company due to so many different things. Could it really be so simple? Anyone else have this insurance? Was it easy?

I have Anthem BCBS out of NH and I have MassHealth (covers my co-pays).  It took longer to get my main insurance approval than it did to get my MassHealth approval.  It took about a week from the time the letter was mailed to the time that my surgeon received an approval letter from them.  I'm sure if a fax was used, it would have been much faster. Congrats on starting your journey!

I was approved within a week. The DR's office sent the required paperwork in and it went pretty easily. I was on BMC/masshealth at the time. Good luck!

Some insurance companies have very little requirements that you have too meet.  Kate, at Dr. Randall's office, will do all the insurance stuff for you.  I know she'd be more than happy to go over everything with you while you are there.  Since she does the submitting and talks with the insurance companies, she'd have a better idea what the requirements would be. I had Cigna, which was a bear to get an approval from.  Persistence on my end had me win my appeal after 2 denials.   Dr. Randall does have his guidelines that you will need to follow, which is the phys evaluation, nutri visits and support group meetings.  He also does not want us to gain any weight prior to having surgery and would like to see us losing weight. Let me know if I can answer any questions for you. 

Thanks so much. You have been very helpful already with the email you sent me. I figured the office would know more about the insurance. I just wanted to get a jump start in case my insurance was one of the companies that make it so hard for people. I will discuss it with her when I'm there. I will also meet with the nutritionist that day.  I will begin to attend meetings as soon as Dr. Randall gives me the ok that he will take me on as a patient. He has done WLS for many family members (at least 7) including my mother, aunt, and cousin. I speak to at least two of them everyday. Family gatherings and Sunday dinners are like support meetings already...lol.  As far as gaining/losing weight goes....I'm what you guys around here call a lightweight. I have 100 pounds to lose...only here would I be conisidered light...lol. I guess thats why I'm hoping he will take me on. I don't plan on gaining, and I will be more than happy to comply with any diet or restrictions he tells me to follow. I'm just so ready to drop this weight for good. Thanks.