Experience w/ BCBS MN in 2005??
I was wondering if anyone has submitted for prior approval to Blue Cross Minnesota so far this year?
My surgeons office faxed in my request on Wed 2/16; I called BCBS on Thurs and Fri and they had no record of my request. The first woman I spoke to stated that if it is not in their system on Mon to have it resubmitted. The second woman I spoke to stated that to not get my hopes up because it can take a week or more for it to show up. When she told me this I was thinking "youre not going to get me to stop calling EVERY day!"
I dont know if it was submitted w/ a fake surgery date on it or not, so I was wondering if tomorrow Monday if they do not have my request in should I call the surgeons office to have them resubmit??
Also, are there any new restrictions they have put in place in 2005?
I want to have RNY.
Sorry its so long!!!!
I am in a different state than you but I ran into the same thing about not being in the system. That was how I found out that the ones submitted with no surgery date are put behind the paperwork that they get with surgery dates. I assume you know that because you mentioned a fake surgery date. Anyway, my approval request was sent by paper, then later, they were told to fax it because BCBS didn't show it. The office finally did fax it, and it hadn't showed up on the system when I called, so I called again the next day, I was approved. (But I had talked at length with the BCBS rep. the day before and he had said to have the Dr. off. them and they would start the file over the phone..... he also said they would get the Dr. office to fax it again while they had them on the phone.) Evidently, that was what worked because when I called the second day ready to have another go with them on the phone, I was I was told I was approved.... but only for one day. If I end up needing to stay longer after the surgery the hospital calls and tells them and they approve it.
I asked about the "Fake" surgery dates because of your other posts. I'm glad to have that info! I'll call insurance again tomorrow and if they dont have record of it again I'll call the surgeons office to resubmit w/ date included if not allready. Then if they don't have it again twards the end of the week I'll have them send it certified mail!!
P.S. My parents think I'm crazy for calling them everyday. They say that I should just let them do their job.
Yeah Right!! I've read too many posts and profiles on people who let insurance do their job and dont hear anything for months!
To me, if I'm paying them I am going to get my money's worth and definatly MAKE them do their job!
P.P.S.
I work in customer service so I know the lingo and what to say to get them Squirming!!