BCBS of AL how long did it take to be approved?
becaboos
on 9/25/05 12:24 am - Greer, SC
on 9/25/05 12:24 am - Greer, SC
Hey, I know I should be more patient but of course Im not!! Ok.. how long does it normally take insurance to review a determination of benefits. Does anyone have any numbers they can give me? BCBS has added some things to what they require for WLS.
I know there is at least 1 or 2 things that they have added.. big one being 3 years of medical notes showing that you have been morbidly obese. They did say dated photographs would work as well.
The 6 months of physician guided weightloss.
My problem.. Of the 5 years of notes I got from my Dr's office she would only take 2 years.. since that is all my Surgions office requires. Then I found out about the 3 years needed.
Also... my notes show my weight and height as needed but the notes do not always address my weight.. since the actual visits would not be covered if I had to see the doctor for this reason. We always talk about my diet but that has always been voluntary and the doctor rarely mentioned my weight/ diet in his notes.
I am worried that I will be denied. I know it is still early but now that I found out the other "required" info I am not so sure things will go as easlily as I hoped.
If they do need additional information do they have another 30 days to review that info? LOL
My surgury date was supposed to be on Monday. I know it isnt going to happen but I would like to be able to have it in October at least.
anyway.. back to my reason for posting.. How long did it take BCBS to approve your surgery once they received the determination of benefits?... (Physician packet)
I am lucky because I have musc options. I have a friend who had some problems. She called BCBS and asked to speak to a reviewer. They told her what was missing in her packet. and she had her Dr. write a letter saying that he had been treating her for five years and had been morbidly obese for all of those years. It worked, she was approved the day after she faxed that letter in.
Joyce from Dr. Byrnes office prepared my packet. They forgot to put in the psychological and she knew about it immediately. Once they had the complete packet it took 48 hours to be approved, the problem seems to be making sure they have everything.
Good Luck and my advice is to stay on top of them.
Mary