Insurance Co Fast Ones?

Horizon told me they don't send confirmation letters for surgery approval... but I see posts from all over the country on the main board about getting a letter in the mail. I'd certainly feel more comfortable if I had it in writing. According to the doctor's office, I'm approved, but when I call BCBS they say I have a precert number and they need more information from my doctor. I have had to fight with them to even get them to discuss it with me, they keep trying to tell me to have my doctor call. I'm just nervous that after I have the surgery they are going to say they never approved it. Has anyone with BCBS ever gotten their approval in writing? Ever had the insurance company say you weren't approved AFTER you had surgery?

Hi Jennifer I also have Horizon BC/BS and they do cover WLS if it is deemed"medically necessary"...That's what I was told when I called prior to making an appointment with a surgeon..And,I believe the doctor gets approval from the insurance company before they perform the surgery so that they're sure they will be paid.Be persistent with Horizon,when I 1st called,I was passed around like a football until I asked to speak to a supervisor,and all of a sudden,they had the answers to my questions....Good luck and let me know how you make out. Dee

I know what you mean when you said you were passed around like a football. I had the same experience twice! All I wanted to know were their specific requirements for WLS. Specifically do they require a physician supervised diet for a certain length of time or is it just any amount of time under a physican's care. I never got a REAL straight answer, but was basically told that there is not pre-set length of time, but they do like to see some form of physician supervised diet. If this is really true or not, I have no idea. I plan on having surgery in June so my surgeon can't submit for approval until April. I guess I'll fin out then! As far as getting a letter in the mail, I am almost 100% positive that my friend who was approved last year through horizon bcbs got a letter in the mail stating she was approved. Good Luck, Heather

I also have Horizon. My surgeon's office stated I was Approved. I'm going to a doctor out of network, so I'm paying for part of the cost. I called Horizon and they told me I was approved. I never got a letter. Jan