hurry up and wait???

delano1972
on 8/22/07 12:36 pm - North Platte, NE
Well, I have submitted everything to Dr. Anthone's office and Christy will be submitting to insurance later this week...I am a ball of nerves, trying to stay busy and not think about it. I have (in my opinion) jumped all of the hoops that BC/BS highmark PA (UPRR) has published in thier G-24 document relating to WLS. I feel comfortable
that my packet is complete, but still worry about what they have that is not published... . Has anyone else experienced this with rail-road BC/BS coverage or are they pretty straight forwared? Hopefully I will be posting that about an approval soon. Thanks for listening to my
ramble. On a good note Dr. A said that I was a perfect canidate for surgery, and should have a very successful outcome..... needless to say, I was very excited about that.

Michelle
Highest 242/Surgery 235/Goal 150/Lowest 158/Current 184 (Started working off regain and heading to goal 02/02/12.)    

Tmom4
on 8/22/07 11:53 pm
I too had to go through the approval process with BC/BS.  Although it wasn't through the railroad.  It was an 8 month long process - I got denied (which is usually expected), I then submitted more documentation from other Dr.s, letter from my husband, mom, etc.  I was then denied again.  Again, I tried to submit more paperwork, a self story/statement, etc. I was then asked to go before their Medical Review Board (sounds more scary than what it really is).  I traveled to Omaha to their corporate office.  It was a matter of 10 minutes long.  The very next day I received a letter stating that I was approved and they would pay 80% of the surgery.  Surgery was then scheduled for two weeks later.  So it very well may take some time, be patient, learn all that you can about the surgery, etc.  The surgery that I was requesting was lap band.  Hang in there. Tmom4
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