Empire BCBS

Hi Everyone, I was just curious how long everyone that has Empire had to wait for a decision to be made.  They told me once they received it that they would have a decision within 30 days.  I call about once a week and naturally get told this could take 30 days.  They received it on May 18th and still have not updated anything on it ................. I am starting to get really worried.

Hiya, I have Empire BCBS...and was told the same thing: 30 days...but it didn't even take that long. AND...that includes a sort of "appeal" where they asked my surgeon for more info (not a denial...just a delay as I understand it). Then, once they had the additional info, it took 3 days. So, all in all it was approved within the 30 days without any real problems. I found out about the need for extra into from my surgeon; I called there regularly to find out if I was approved. When you say you call once a week....do you mean you call BCBS -or- your surgeon? What is your BMI? Any comorbidities? Keep us posted but as far as I'm concerned, BCBS was awesome! Hugs, Karen

It's me again! I just looked at your profile and your BMI is high enough for BCBS to not require comorbidities....but I have a question: Where is DePaul weight loss center? I have not heard of it. Thanks, Karen

Good morning Halfpint9701, I also have Empire, BCBS. I go for my first consult tomorrow. But When I called the Insurance Company, Ms. Wilson, told me that it does not matter if your doctor calls for pre-certification, I must also call and asked for pre-certification from medical management services. Perhaps you did this already when you called. But if not, make sure that you are specifically asking for pre-certification and the name of your doctor. She told me that once we do that, they can then call our doctor. I wish you all the best!

Hi, I have Empire and I got my approval letter in less than two weeks.  They gave me no problem at all.

Good Luck,

Janet

Hi just wanted to let you know, that I have BCBS and was approved, Paperwork was sent in April 2nd and was approved April 28. My  highest BMI was 40.1 -It is so hard waiting hang in there!!!    Tracy

I worked at Empire for a year (their treatment of employees should be heavily evaluated...don't even get me started ), so I know what you're going through. But if it is any consolation...the people there are more than anxious to give you a yes or no. The longer things sit in limbo (in their processing bins) the more stressed they get. I was in Provider Services, so I know for a fact that Precertification is the key! Make sure everything is precertified and annoy member services if you have to, to make sure you get 100% complete, accurate info on what you have to do for your policy. I have seen a lot of stress and heartache from Empire members, because they didn't ask enough questions and subsequently claims were denied. There's nothing wrong with calling a couple of times to get different reps, just to make sure you get consistent answers. Rather safe than sorry. Wishing you the best, sunshine.

Hi I had Empire BC/Bs and I received my approval in 48 hours. My surgeons office took care of everything. I did not have to deal with them at all.

Thank you all so much for your replies.  I will try to hit on all the questions I saw.  My BMI is around 42 my co-morbs are gerd, edema, and sleep apnea.  DePaul Weightloss is in St. Louis Mo I actually live in Illinois but my employer NBTY is located out of Long Island so therefore my insurance comes from there also.  I am a bit confused that everyone is saying pre-cert when I spoke with member services they had said that prior authorzation comes before the pre-certification that it will come after they decide if it will be approved or denied.  Everyone I keep speaking to just tells me that there has been no update just that it was received on May 18th and to please allow 30 days blah blah blah   should I be speaking to a certain department other than just member services?  They have all been very vague with me.  I think I will call the surgeons office to see if they have heard anything yet.  Although when I turned in all my paperwork they said " you will hear long before we will" so I just 'assumed' but i will check with them tomorrow.  Thank you all for taking the time out to reply.   I like this board much better than my own.