I Got Approved - Or Did I?

Hey Everyone: I just got back in for North Carolina and thought I would give BCBS a call and see if they approved me for surgery.  I called and spoke to a really nice lady.  She said that I had been approved for inpatient hospitalization for June 10th through June 12th.  But there wasn't a need for approval for a procedure.  I'm like Huh?  So with Federal BCBS, does that mean what everyone always waits for is an approval.  They said I should get a letter in the next couple of days.   Tell me, should I be excited.  Well,  I'm already am.   June 10th is my date.  I origionally posted thinking that my date was June 8th.  But that would mean it would be on a Sunday.  Any good car rental place?  My parents are coming and they would like to  have a care while they are here.  Also, how long did you family and friends stay with you while you ha surgery? Denna and Denver

Denna That is great to hear and wow that was quick! WOOT!  I was in the hospital for 3 days and was ok after 7 days to be left alone.  It was good, just need someone to make sure you are walking and drinking and not just sleeping the whole time.  I am so excited for you, that is great.  BWI has EVER car rental place you can think of.  I usually rent from Alamo.  Best Wishes and keep us posted. Hugs Kristen

You and I are in exactly the same situation.  I am also with BC/BS Federal, and I was given a surgery date of June 10th. I, received a letter from BC/BS (dated 5/2/08) stating that I was approved for hospitalization for my procedure. My letter states: "CareFirst Blue Cross BlueShied has received a request to certify an admission for the above named patient (me!).  The hospital stay has been certified based upon the information provided and available at the time of certification.  We will follow this admission throughout the patient's stay.  If additional days are requested, we will evaluate the request to determine whether they are medically necessary. "Certification is a requirement of your health benefit plan.  It ensures that the admission is medically necessary as defined in the Blue Cross and Blue Sheid Service Benefit Plan, and that care is delivered in the most appropriate setting.  The approval decision is based upon the clinical information provided by the patient's physician and/or the facility.  Unless we were given misinformation, we will not change our decision on medical necessity. "Although certification is required for the admission, it is not a guarantee of benefits.  Benefits are available only if the patient is eligible at the time of admission and the factors resulting in the hospital admission and subsequent inpatient are consistent with the information provided at the time the authorization was issued.  Available benefits may be subject to other contaractual exclusions, including those identified in the Blue Cross and Blue Sheild Service Benefit Plan brochure. "Please be aware that, if you are being admitted to a Non-member facility - that is, a facility with which we do not have a contract - you may be responsible for significant out-of-pocket costs for this admission, since the facility is not obligated to accept our allowance as payment in full.  If you need assistance finding a Preferred facility, or have any questions concerning this certification, please contact the Member Services Department at the number provided on your membership card." ** I am one of those people who will have to pay the surgeon's fee out-of-pocket (Dr. Schweitzer doesn't accept BC/BS), but I can submit receipts and bills of service to BC/BS and be reimbursed.  Fortunately, my stay at Johns Hopkins is fully covered. So....I'm taking my letter as a sign that I have been approved.  I hope I'm not reading it wrong. Good luck to a follow June 10th'er.

I have Aetna. I got seperate approval letters for surgery and hospitalization. I asked everyone NOT to care for me. I hate having anyone have to take care of me. I'm strange, lol. I came home from hospital 2 days post-op, and was out of bed for good the next day.

Deena:  Congratulations.  I know you are excited.  I got a similar letter from Coventry healthcare and I called them just to make sure that I was approved.  They verified that I was.  These next few weeks are going to fly by.  My date is a week from today.  Enjoy the ride.

Congratulations Denna!!!

I would be skeptical too!  But yay for you!  you got approved for the hospital stay.  You don't need approval for the surgery, wow!  That's great and very surprising if it's correct!  I hope you hadn't jumped through a bunch of pre-op hoops for nothing.