Anyone know how long approval takes from Medicaid/Badgercare?

I have my last nut visit June 23rd and then everything is submitted to Medicaid/Badgercare, I have Compcare as my HMO.  Any idea how long it takes to hear back with a decision, I am so ready for surgery!

Below I'm c&ping my reply to you from the Insurance Update thread.  If I got the name wrong, I apologize.  Also, another suggestion I have is if you have the option to change from Compcare, look into changing asap.  They have very strict guidelines.  We have two choices here: Compcare and Group Health.  I used to have Compcare.  With them I had only one medical group to choose from.  With Group Health I have two.  Actually, on another thread I wrote that the only change from my first and second try at the panniculectomy was a 20 or 30 pound weight loss.  That's incorrect.  You just reminded me.  It was also a change from Compcare to Group Health.  Look at your HMO guidelines very carefully.  It takes 30 days for a change to become effective, so if you do decide to switch you'll want to do it as soon as you can. Good Luck!  Sharon ******************************************************************** Hi!  From what I've seen, approval for concrete medical reasons are usually 30 days.  If you're denied the first time, as many are, make sure you appeal right away.  The process shouldn't take more than 60 - 90 days.  This is me thinking back to 2005, though.  Things could have changed since then.

The most important things to have on your side are a PCP and dietician who will advocate for you.  They are the ones who will be documenting your progress, making referrals, filling out forms, etc.  If you aren't sure they'll back you up if you're denied, take advantage of the Ombuds program.  They helped me in 2001 and they've helped me in other situations since.  

As for me, my hearing is next week.  It's going to be interesting presenting my documentation with a drain sticking out from a surgery just 9 days prior!  Sometimes, though, seeing is believing.  Maybe seeing how far the skin hangs, how awful it looks on someone as short as I am and how it gets in my way will be what it takes to change their minds.

Good luck with getting your approval!  Let me know how it goes.

Feel free to ask me anything and I'll answer if I can. 

Hi Sharon, thanks for the reply.  All the doctors I see are with Gundersen-Lutheran health system.  I go to my pcp locally, but for all appts. for WLS I go to La Crosse.  When I first go on Badgercare, I asked for Group Health of Eau Claire for the HMO, then I was told they didn't cover Gund-Luth, so I had to change to Compcare.  So far I have no complaints with them.  I was told with Badgercare I had to have 6 mo. of nut. visits ( have my last visit June 23), have already done my pysch. visit and got ok'd there, had consult with surgeon already too.  I meet requirments for BMI.  Do you know of any other requirements.  I don't have anything from Compcare to read on what they require.  I haven't seen my pcp since I started the process for WLS, I just started it on my own, and surgeons office has been helpful so far.  I will appeal right away if I am denied.  Do you see any reason why I would be denied other than they just want to save the money?  I am getting so nervous about being approved.

I have straight Badgercare (no HMO). I called them last week when my surgery pre-authorization was sent in and they said they had 20 days to approve or deny. I was approved today, it took them 6 days for my approval. I hope this information helps.

Congrats on your approval!  I called the HMO about a week ago and was told it would take about 7-10 days for a answer back but it could even be sooner.  Dr.s office is sending my packet in this week as soon as I get my weight history from another clinic I went to a few years ago.  Thanks for the info.  I hope I get approved as fast as you did.

Thanks for the congrats and well wishes! I will keep my fingers crossed that you get your approval quickly too! Best wishes ~~