Does anyone have any experience with the approval process through Fidelis Care NY?

A Brand New Me
on 10/4/10 10:35 am
I am about to start making the preparation for the approval process after my next doctors visit.  According to my insurance company Fidelis Care NY will approve any surgery as long as your physican says that the surgery is medically necessary.  I am pretty sure she would agree with me on this.

I was wondering has anyone had any experience with going through the process with Fidelis Care NY?  Anything to expect that I wasn't told.  I tried to drag out information out of them about exactly what I need to do on my part so I can get the Vertical Sleeve, but it was like pulling teeth.  How long did you get approved for the surgery?  Did you have to go on a medically supervised diet?  How long did it last?  Was there a long wait? 

I would like to be prepared mentally, if this is going to be a long battle. 
adkmtngirl
on 10/7/10 4:04 am - Brant Lake, NY
 I have Fidelis too, and according to the surgeons office I chose to go with after I go on Friday I will have met all of Fidelis' requirements. So, then it will be submitted & I should hear from them within 2 weeks (the wait time I got from my handbook, but I was also told the same wait time for my knee surgery approval and got that within 24 hours.) I know when I called Fidelis it was like pulling teeth as well, that's why I asked around too. 
Kristina
       
 
A Brand New Me
on 10/7/10 4:09 am
Could you tell me what are Fidelis requirements for approval? 
readyforchange2014
on 8/1/14 2:29 am

Did you have to diet for 6 months 

amc9284
on 10/16/10 11:07 am - Saranac Lake, NY

I had no issue with Fidelis.  I have a little inside connection and was told my clinical data was sent on a Friday.  It was followed up on then next Monday and didn't go through, so it was sent again about 4 hours later the office receive confirmation that I was authorized with the insurance to have surgery.  I have done the whole pre-op process to have my information sent to fidelis.  I was told they were actually one of the quicker ones to get back to the offices. I'd call and talk to the people in your bariatric office and see if someone would let you know what the turn around time is.  The next day I was scheduled for my surgery (and this wasn't even 2 weeks ago) I have my pre-op appointment on the 18th of Oct. and I have surgery on Oct 27th.

Good Luck

(deactivated member)
on 7/28/11 9:50 am - Canajoharie, NY
Hi I saw your post and was wondering if you every had your surgery. I am about to start the process myself and i have Fidelis Care NY and was wondering what I am expecting. If you had your surgery when and how is your progress so far.
Giselle C.
on 3/27/12 8:01 am - NY
 Im going for my first vivist with the surgeon this Friday (3/30/2012) I also have Fidelis Care NY. I have been trying for many years to get approved for surgery in Miami, but had no luck. Hopefully this will be the last try and actually get approval. What were your requirements? Did you get approved? I really want to get approved and I also want to make sure I have everything i need to submit to my insurance.
glamour4503
on 6/27/13 6:07 am

DID FIDELIS CARE APPROVE YOUR SURGERY?

lori12969
on 5/13/15 3:13 pm

I am at the end of my pre- op process. All in all I had to go to an informational session to learn what bariatric surgery was and what kinds of surgeries there were to choose from. The pros and cons of each and meet the Dr. doing the surgeries.  then I had to pay $50 for the initial evaluation as it was not covered by Fidelis Ny they said. After that they gave me a handbook with all the next steps.  They sceduled me for a sleep study to determine if i had sleep apnea, and then the next morning a "Bundled Testing". Where I had to do a blood test, a Urine test, weigh in, have a sonogram of my liver, kidneys, pancreas and an extra of my lungs and heart. I had to meet with a psychologist and a RN and a physical therapist, a nutritionist was scheduled for another day as well as a breathing test called a pulmonary function test and then a second sleep study.. part 2... an echocardiogram  and then go to a class to learn how to eat right. That is the process where i live.  all in all it took me from Early March and will be completely done on May 21st. and will then have to wait for clearance... Not sure how long that will take but i'm assuming like up to 3 weeks. Hope this information helps!

Stephmyers95
on 10/8/19 5:42 pm

How long did it take I have my first appt on the 25th so ready alredy ll3 lbs away from 20 lbs gone and haven't even had first appointment.

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