DOES ANYONE HAVE EMPIRE BCBS HMO????

iM TRYING TO PRE-CERTIFY FOR THE SURGERY AND I NEED TO KNOW SOME INFO ON EMPIRE BCBS HMO... I THINK THEY ARE GOING TO GIVE ME A PROBLEM. HAS ANYONE HAD DIFFICULTY WITH THEM? WHATS THEIR AVG TIME FOR APPROVAL? THANKS TRICIA

Hi Tricia: I have Empire Blue Cross/Blue Shield HMO. In order for my surgery to be approved I needed to go through all of the steps, such as: psyc. eval, upper endoscopy, pulmonary functioning, letters from my PCP and a visit to the nutritionist (mine cost $250 up front). After that my surgeon's staff submitted all of the information, and within a week or so, I was approved! I was pretty shocked because they can be a bit difficult to deal with at times, but that wasn't the case when it came to being approved for the surgery (LAP RNY). I also has some comorbities (sp?) which probably was why I was approved so quickly. So now,3 weeks after surgery, I feel really great. Hope that was helpful. And best wishes throughout your journey. Karen

hI kaREN, gLAD TO KNOW THAT YOU FEEL GREAT!!! iM WORRIED THAT MY DOC'S LETTER WILL NOT SUFFICE FOR PRE-APPROVAL... HE IS A NEW PCP I HAVE AND HASNT KNOWN ME FOR A LONG TIME. I GAVE HIM ALL MY DIET HISTORY (WHO THE HECK NOTIFIES THEIR DOC EVERY SINGLE TIME THEY TRY A NEW DIET) AND WROTE A LETTER BASICALLY BEGGING HIM FOR A GOOD LETTER. WAS THE LETTER EXTREMELY IMPT FOR THE APPROVAL? IM HOPING THAT HE WILL DO IT... AS OF THURSDAY I WILL HAVE NO MORE TESTING. i ALSO HAVE SEVERE SLEEP APNEA AND IM HOPING MAYBE THAT WILL ENCOURAGE A QUICK APPROVAL. THE SURGEON I AM WORKING WITH SEEMS TO BE FANTASTIC. AND I REALLY BELIEVE I WILL BE SAFE WITH HIM. SO WISH ME LUCK. THANKS AGAIN!

OH WOW... I JUST READ YOUR PROFILE... I AM WORKING W/ DR POMP TOO....

Hi Tricia: First of all I need to tell you that Dr. Pomp is wonderful. His calm demeanor, sense of humor and confidence in his abilities helped me to make my decision regarding a surgeon. Besides that, on the day of my surgery,while I laid on the operating table, he asked how I was feeling. I replied, "Petrified." He said, " Don't worry, I'll take good care of you." And then he held my hand until I went to sleep. Everytime I think about it, it brings tears to my eyes. As for the PCP letter, Dr. Pomp's office provided me with a "sample letter" to give to my PCP which gave him the guidelines in which he should write the letter so that I would have a better chance of getting approved. Keep the faith and I am sure that things will go fine. Best Wishes, Karen

Tricia - I have Empire BCBS PPO - I don't know if they are different on the HMO side of the house, but I also have a new PCP and I was approved without an issue. The diet history should be as complete as you can make it (my surgeon's office had me include estimated start and end dates, start and end weights and comments....whatever it was, it worked!! Good luck!!!!!