Horizon BCBS- still waiting

I am getting so frustrated with horizon bcbs. They received my paperwork on April 20 and I still haven't heard anything. On Monday my file was put on supervisor priorty. I was supposed to have an answer within 48 hours. Well here we are more than 48 hours later and still no answer. Today I was told that they will contact the med review department to find out when my file will be looked at and call me back tonight or tomorrow. Well I won't hold my breath! I am just so disappointed because I have always heard such great things about horizon approving surgery. I was hoping to have surgery the week of June 21st. If I don't get approved soon I'm afraid I will lose my date! I hate being in limbo. Thanks for listening. Any advice would be appreciated. Heather

Hi Heather. I too have bcbs pos. My surgeons office took care of everything with the approval. Is your surgeons office taking care of the approval? I had my first appointment March 30 and was approved April2. I had a letter from my PCP stating that I had been trying off and on for about 5 yrs. but with not much luck.I have tried phen-fen, meridia, etc... plus I had a copy of my blood work(high triglyceride, cholesterol).The letter really helped I think. good luck!!!

Yes my surgeons office sent them a letter from my pcp stating my medical issues related to my weight along with my diet history and letter of medical necessity. According to bcbs my Dr is requesting a predetermination, which according to them is more involved than a precertification. The surgery coordinater at my dr's office told me that they have sent in other people's paperwork to horizon (after mine) and have gotten an answer the next day. According to horizon it is in line to be reviewed. I am calling both horizon and my surgeon first thing tomorrow morning. I am going crazy waiting! Thanks for your reply. Heather

When I called BCBS to find out my status, they told me they would only talk to my surgeon's office about it. My response was, well, if you're not going to cover it, who do you think is going to have to pay for it? I'm the customer! Luckily they didn't hold my attitude against me and I was approved and they already paid the hospital & docs so I know I'm out of the woods. I hate insurance companies. Best of luck to you, jen

HI everyone, Thanks for your replies. I found out I was APPROVED on Thursday. Of course it was after a big run around. At first they told me that they needed more info about the surgery specifically about the amount of intestine being bypassed. I called the insurance woman at my surgeons office and she called them right away. The first woman she spoke to hung up on her. Then she called a different number and spoke to a very nice woman who took some info and gave her my precertification number right over the phone. Hurray, I am approved after 5 weeks of waiting. I wish everyone the best of luck. I am looking at June 21st or 24th as possibel surgery dates. Heather

Hi Heather. It's a little late, but I just wanted to let you know I'm happy you got your approval! Yay! -Judy