wellcare of georgia

does anyone happen to know how long it takes wellcare to approve wls in georgia? I would like to get additional advice about using Wellcare in Georgia.   

Hey there!

I have no experience with Wellspan GA, but I am in healthcare reimbursement, so here are a few thoughts:

1.  Where are you in the process?  Do you have a surgeon picked out?  Their office will most likely have experience and can tell you the usual turn around time.

2.  If not, pick up the phone and ask the insurance.  They should be able to tell you A) whether your plan covers the surgery (very important because although they may have policies regarding a particular service, does not mean your particular plan covers it) B) exactly what the policy is (what do I have to do to be eligible for this surgery)--they should be able to read it off to you and C) they may need to transfer to you to the preauthorization department, but someone at the insurance should be able to tell you the outer parameters of when you can expect an answer once the request for authorization is submitted.

3.  Once you get to the authorization stage, and your information is submitted, don't be shy about calling periodically (once a week) to check on the status.  It won't hurt, and it may move your case along faster.  Hearing directly from patients makes it more difficult for a case manager to say "no" and additionally, they may speed along your case if they see a patient is checking in periodically (just human nature to want to get the calls to stop).  :)

4.  When you do talk to the insurance, be pleasant, polite, but don't be afraid to be firm as needed.  (ie, I know you have a six week window to make a decision, but this affects my timeframe off from work.  Is there anyway you can expedite this?  etc.)

Have to do 6 months supervised diet, do psych evaluation etc but once you get everything in they have 30 days to make a decision. It took a little under 3 weeks in my case.