BCBS approval time frame

pommom3
on 12/30/10 4:22 am - MI
 I have BCBS and I am waiting on them to approve the surgery.  It does not require pre-approval but the hospital and surgeon require it to be sent in and approved.  Anybody else had to do this?  How long does it usually take BCBS to approve?
                    
Pam T.
on 12/30/10 8:04 am - Saginaw, MI
 BCBS will not pre-approve your surgery so your doc will be waiting a very long time. Instead, BCBS expects the doctor to know the requirements for payment and make sure that criteria is met before they do surgery. 

The insurance clerk at my surgeon's office was in charge of making sure everything was in order. Once that last piece of paper was submitted (letter from my PCP) I had a call from her within the hour and we were scheduling surgery. 

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pommom3
on 12/30/10 8:10 am - MI
 they tell me that they have an arrangement with BCBS to pre-approve it.  I am really frustrated because they are telling me that it could take 8 weeks to hear back from BCBS but I have called BCBS and they say there is  no pre-approval as long as I have met all requirements.  Very very frustrated.  Any ideas on how I can speed this all up?  I met all requirements plus more!!
                    
Pam T.
on 12/30/10 8:13 am - Saginaw, MI
Mmm.... I doubt the surgeon's office has some special arrangement. Unless you have BCBS that's not Michigan (other states still require pre-approval). So it sounds like you need to get in touch with a supervisor at BCBS and get them involved. Tell them your doctor is jerking you around and you need their help. And if that doesn't work .... find out who the director is at your surgeon's office (it's likely not your surgeon) and make some noise.

My Recipe Index is packed full of yumminess!
Visit my blog: Journey to a Healthier Me  ...or my Website

The scale can measure the weight of my body but never my worth as a woman. ~Lysa TerKeurst author of Made to Crave

 

pommom3
on 12/30/10 8:16 am - MI
 Ok thanks so much for your help. I will try calling a supervisor at BCBS on Monday.
                    
pommom3
on 12/30/10 9:08 am - MI
downsized
on 12/30/10 9:11 am - MI
I just got word from my surgeon's office today that BC/BS has authorized my surgery.  I have Smart Health which is a BC/BS product.  It took less than one week for the office person to complete the process.
pommom3
on 12/30/10 9:09 am - MI
 How long did the whole process take you from information meeting to surgery day?
                    
Pam T.
on 12/30/10 9:11 am - Saginaw, MI
It took me about 15 months --- but that's because my PCP screwed up my physician supervised diet history and I had to do the 12 months diet a second time. So in theory, it should have only taken me 3 months. But things were different 3 years ago.

My Recipe Index is packed full of yumminess!
Visit my blog: Journey to a Healthier Me  ...or my Website

The scale can measure the weight of my body but never my worth as a woman. ~Lysa TerKeurst author of Made to Crave

 

downsized
on 12/30/10 9:14 am - MI
I attended the informational seminar 7/14/10. The office is going to call me about my surgery date next week.  I am hoping for a February or March date. 
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