New Member just saying Hi and sharing some concerns!!

Hi all I am a 30 year old man waiting for Insurance approval!! My insurance carrier has aproved hundred of these surgeries in Wis.. Heres my dilema call it negetive thinking but it has been like ten day since my paper work has been turned in and I have not heard a word. I called the carrier and they said if I had a reconmendation from a Doctor it would most likely be approved. This was great to hear but I can't stop from thinking I might be the frst one DENIED. I know my feelings are mostly anxiety related but if anyone who has Badgercare and has had the surgery or has been approved could reply and let me know their experiences it would be greatly apprieciated. Thank you

My dh and I both just got our approvals. If your file is still pending...Monday AM call your surgeon's office. Tell them THEY NEED TO CALL MA/EDS (give them the number on the back of your card) and have them expidite this process...we did just that. The next day my dh was approved. By law they have 20 days to approve or deny. Who's your dr? I had a hell of time getting my clinic AND MA to get their ducks in a row and turn in the right stuff..... Gala

Gala, Thank you for your quick reply. My Doctor is Dr. Reising with Saint Micheal's Hospital. Bonnie handles the whole bariatric surgery department. She has been great and turned my paper work in last friday. I called her yesterday and she reassured me they had the paperwork and we are awaiting approval. Saint Micheal's has it's stuff together with nearly a 100% approval rate. I know I am prolly just being overly anxious. Do you think it would help to call myself to the carrier's office. I have called before I started this whole process and the person who answers the phone tells me that if it is deemed medically necessary then it should be covered. (SHOULD) never yes it would be. That is what makes me nervous. I hate waiting. I have completed the sleep study,physc evaluation,physical and education poertions and all that is left is the surgery. I just can't imagime spending the last two months and thousands of dollars for a disapproval. That would truely suck.

I HIGHLY reccomend you call them. I had my preop appt this week w/my surgeon. They STILL had not received notification that it had been approved!!! So they had to call and find out. I knew beccause I called them everyday for nearly 2 months. My file was sent back so many times and had I not called them it would have taken my provider days to get the stuff back and then resend it. This way they were able to call Provider Services and find out. SO when you call...call the number on the back of your card. Then select 2 and then 4 and then tell them you would like to check on a prior auth. They will ask your ssn, dob, full name, dr and procedure.... They will tell you WHEN it was entered into their system, sometime how long it has been "pending" and if it was approved. IF it was approved then ask for the PA Approval NUmber.. Call your provider and she can then call and get verbal approval. My experience is MA wil either approve right away OR it will sit on someone's desk..I know both ways that it has happened. Give them a call. Be proactive!! My DH and I have just got our approvals about a week ago. He has surgery on the 14th and mine is July 6th. Gala

Gala, Thank you again for your advice. I will follow your instructions on Monday Morning and see. I am very nervous and hope all will be fine. How long did it take for your surgery to be approved and then also how long after it was approved was it untill you final surgery date was set. I have a sleep study scheduled for tomarrow night 6-7-04 final step before surgery. I am not liking the fact I have to tuse the CPAP machine but if it makes me sleep better so be it. Thank you CONGRATS ON YOUR SURGERY DATES. MAY GOD BLESS YOU AND GIVE YOU BOTH THE ABILITY TO HAVE A SAFE AND SHORT RECOVERY TIME!!! PJ

Hey PJ - how did your sleep study go? I had mine about a month ago and barely slept a wink.

Hey Amy, Thanks for asking and to tell you it was Ok. This is my second study the forst proved I had sever Blockage type Sleep Apnea. I had to use the CPAP machine for this study and the Doc. gave me 10 mg. of ambian slept like a baby except for the ocassional toss or turn. That CPAP forced air is weird at first but I have not slept that good in years. I also called the Insurance company like Gala suggested and it was a good thing I did they need additional info from my doctor's office. So I called the hospital and they forwarded the info this afternoon. Hopefully now I can get a answer soon.

Hey there bro...keep your chin up....You will get approved!!! Just make sure you listen to your elders!!!! (meaning me of course) You take care..Love your sis!!!!

Hey Sissy, You got it I promiss, I will listen to my elders (mainly You) I wont be jumping on a trampoline within days of surgery. (LOL) Love ya, PJ.

Just remember...Do as I say, not as I do!! I am feeling a bit "under the weather" right now...but I think I over ate! You feel kinda miserable when that happens...trust me! Had my dress fitting again today....Looking good I may say!!! You...I want a dance with this weekend!!!! Love your sis...Lora