No Pre-Authorization??

I have BCBS of Mi. My surgeon is in Tulsa, Ok. They have faxed BCBS twice for pre-authorization, but when I call they keep saying they didnt receive anything and that they do NOT give pre-authorization just make sure I have met my requirements. My surgeons office told me that they require written approval. Is there anything I can do??  Shonna

Shonna: You sound exactly like me.  I have been going through this exact same thing since August of this year.  I too have BCBS of MI and have been getting the same run around.  My surgeon has submitted a pre-auth request twice and BCBS keeps saying they have no record of it.  I took the bull by the horns and submitted it myself, and within two weeks received a letter back stating that the doctor has to request it, that I cannot. I am at my wits end with this and have found no help anywhere.  My surgeons office is tired of hearing from me.  I think they've given up on me too.  I have met all of the requirements but my surgeon will NOT do the surgery without pre-authorization.   I know this doesn't help you at all, but it is somehow comforting to know that I'm not the only one going through this.  If I find an answer, I will definitley let you know, and I'm hoping you can do the same.

Yes it is good to know I am not the only one pulling my hair out!! LOL The lady in charge of insurance said she will call BCBS today. So I hope I get some good news. My insurance is changing to UHC in January. Not sure if my new policy will have a exclusion or not. They say it is covered, but a little leary about taking their word for it yet. Plus my deductible is already covered for this year and not much left on my out of pocket max.

Will let you know if I hear anything. Good Luck!!!

Shonnajo, I think we may have the same employer.  I also have BCBS and my company is switching to UHC in January.  We have a plant in Neosho, MO.  Does your employer happen to make furniture? I've had the same run-around with BCBS.  I went to the surgeon for my first appt on Sept 29, and the ins co has yet to send anything to the dr's office.  I have called both BCBS and the dr's office numerous times.  From what I can understand, BCBS only responds to pre-certifications, not pre-authorization requests.  My dr's office won't even file because they're not sure I have met all the requirements.  The dr's office person spoke to BCBS, and they recommended I go ahead and have the surgery and self-pay, then file to BCBS.  WHAT????   What could they possibly know after the surgery to make the decision whether to pay or not that they wouldn't know before surgery? I think that is the most ridiculous suggestion I've ever heard. Anyway, I had asked about UHC's requirements, and they require proof of BMI over 40 for at least 5 years.  I won't meet that requirement, so it looks like I'm out of luck.   Does anyone know if there are exceptions to the BMI > 40 for five years clause if there are co-morbities?

Hey there!! Yes my husband works for Lazyboy. Who is your surgeon? I called and called BCBC and they would not do the pre-authorization. They did send me my requirements back in March I believe after calling everyday to bug them.    I am going to Dr. Gorospe in Tulsa. Denise my case worker said that they had to have pre-authorization but gave her the 800 number the insurance gave me for her to see if I met my requirements and she finally emailed me to say I met them so I am approved. I am now waiting on Lisa for my surgery date and pre-op appointments. I tried to add you as a friend last week and email you. Have you checked your messages on OH? Would like to chat with you, Shonna

I tried also to add you as a friend, and sent you a message also.  Have you checked your messages?