Did I get Approved or not?

CuteDonna
on 11/26/04 6:09 am - Effort, PA
I got this letter in the mail today from BCBS. This is what the letter states and I'm wondering if I'm reading it right. The last statement "this letter is not a guarantee" has me scared. I don't trust insurance companies. ******************************************************************************************************************************************************** Dr. Ms. C; This letter is in response to your request for an appeal of denial of Bariatric Surgery. A physician who specializes in general surgery and who had no involvement in the original denial reviewed your request and the available clinical information, based on the review this review of the original denial has been reversed. Decision: Certify proposed bariatric surgery. Reason: Approval is based upon recommendation by an external peer reviewer, after consideration on the member's individual clinical cir****tances. The member has met all BCBSIL medical policy criteria for proposed bariatric surgery. This letter is not a guarantee of benefits as eligibility requirements, terms, conditions and exclusions of the member's health plan, such as pre-existing condition provisions may apply.
Tammy H.
on 11/26/04 8:51 am - Collinsville, OK
YES! Now you just need to call the doc to set a date. Congrats.
CuteDonna
on 11/26/04 10:45 am - Effort, PA
Thanks and I still don't believe it. Donna
gary viscio
on 11/26/04 11:39 am - Oceanside, NY
RNY on 07/01/03 with
You crack me up, you sound like me, I don't trust them either. When I called to check on our appeal wednesday they said a decision was sent and wouldn't say what it was. I thought I would have received the letter before you. Yes you did. Be healthy and happy. Keep in touch. Gary www.obesitylawyers.com
CuteDonna
on 11/26/04 6:38 pm - Effort, PA
Gary, Insurance companies are like people that dangle candy in front of a baby. After a while that baby won't trust that person anymore and when your pulled through the ringer like some of us have been in trying to get approved (My case since June of 2003) you look at every letter that your insurance company sends as candy being dangled in front of you. Are they going to find another reason to knock me back down in the dirt. I think I'm over the shock now. Yesturday I was in a BIG fog of denial. NO WAY DID THEY APPROVE ME!! IT JUST CAN'T BE, IT MUST BE A MISTAKE, MAYBE THEY SENT ME SOMEONE ELSE'S APPROVAL LETTER. There was times I wanted to scream at you and a couple of people told me to sit back and let Gary do his job and I you did it. WAY TO GO GARY Hugs Donna
gary viscio
on 11/27/04 12:00 am - Oceanside, NY
RNY on 07/01/03 with
It takes time. Trust me I'd like to scream every day with how they play these games. It's more work then it should be. Congrats again. Gary
Roberta A.
on 11/27/04 9:10 am - Marietta, GA
Congratulations Donna! (and Gary) I was one of the people who told you to relax, and let Gary earn the money you paid him. See how everything worked out for the best!?! You have showed great patience and tenacity. These qualities will serve you well post op. Hugs, Roberta
CuteDonna
on 11/27/04 9:51 am - Effort, PA
Thanks Roberta, your a doll Yes, you where the one that told me to cool my jests. Most of the time I was pissed not sure and upset These insurance companies love to keep your head spinning . Now my husband is freaking out because I changed insurance companies in a panic and he is scared they won't cover the after care once my insurance kicks in, in January. I'll call them and find out on my next day off. My husband said to cancel the insurance but I don't think I can and I don't think he can change his either but thinks we can. We are locked in once the enrollment period is over, right? Donna
gary viscio
on 11/28/04 4:41 am - Oceanside, NY
RNY on 07/01/03 with
Thanks, you are a doll. ;)
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