federal BCBS insurance?? anyone have info.??

This beats all I have ever heard. After having all my pre-tests done and getting surgery clearance, I now find out that my insurance doesnt have to "PRE-APPROVE" my surgery. My coordinator thought after contacting my ins. that they would cover it b/c they told her it didnt have to be approved. (she checked into it before my pre-tests) Now, I find out that no, they dont approve or deny the weight loss surgery UNTIL AFTER YOU HAVE IT DONE!!! DOES THIS MAKE ANY SENSE TO ANY OF YOU?? i COULD HAVE IT DONE AND THEN HAVE THE CLAIM DENIED. HELP!! My coordinator is working on it, as it became a big shock to her also. This just makes me want to . Anyone have any suggestions? My surgery was supposed to be BEFORE Christmas, now im hearing the 1st friday in January. Thanks for any input you may have on this . Lisa

Hi Lisa, I have Empire BCBS PPO and guess what after I went through the same thing I found out that they do not have to preapprove. They said that all they have to do is call and get the percentage covered, get the correct codes to send the claims through. They said that it was important that they submit the right codes or the claim can be denied. You may want to tell your coordinator to make sure that she calls and ask for the diagnosis and procedure codes. My surgery has been put off until January 5th. So I guess we are in the same boat kid! I am so sorry that that happened to you too. Call me at 601-981-6727 if you ever wanna talk. Jaunine

Lisa: I had my surgery done back in August 2003 and my Federal Blue Cross/Blue Shield wouldn't touch it. They would, however, pay for the gastric bypass, but I was told that lap band surgery was still (by them) considered investigational and experimental - even though the FDA approved it for use in the U.S. in June 2001. I didn't argue with them about it. I do know that I have read posts on the different message boards where Federal BC/BS did pay for other's lap band surgery; but I don't know the specific cir****tances. You know those insurance companies can tell you most anything - even if it sounds as dumb as having the surgery and then having it approved for coverage or not after the fact. Geez, what a crock. They can cover their butts by saying that it's their "policy." Good luck in your negotiations with your insurance company. I'll be curious to know how yours comes out.

THANKS FOR THE RESPONSES CAROLNY AND JAUNINE- MY SURGERY DATE IS MONDAY ,JANUARY 26TH. I JUST FOUND OUT YESTERDAY!! JAN.20TH I AM NERVOUS AND EXCITED TOO. TALK SOON. LISA