Question:
How long does it usually take for BC to make a decision?
— gsgcjar (posted on October 8, 2009)
October 8, 2009
It depends on if you have all of your requirement paperwork and testing
done, it could actually be within a couple of weeks if not sooner. Make
sure you have all of the T's crossed and the I's dotted, otherwise it will
take twice as long. And be sure that labs are up to date and not one piece
of information is missing. I got denied because I didn't have one paper
they needed. Also, the surgeon that is doing your surgery will be the one
to submit (insurance dept) and if need be, file an appeal. I filed the
appeal to get approved and gave them the one paper and I got approved
within 2 weeks. So, it is all about making sure you have it all in the
pack. Hope it goes well. Be sure your doctor isn't asking for tests that
you haven't had done yet. I had a check off list of items I needed to do
for testing etc. and that really helps. Labs have to be within 2 weeks, I
believe. Also, you will need to have a supervised diet for 6 months. I
took my old Weight Watchers stamped booklet from 1998 and used that as well
as a letter from Jenny Craig from when I was there in 2000/2004. So I
don't see that it needs to be a current diet. Just proof of an attempt to
lose weight supervised. It doesn't have to be supervised by a doctor.
Also, include every and all weight loss diets, pills, programs, that you
have tried in the past and how much weight you lost on each one. That
shows a huge attempt on your part to lose weight and it also proves we
can't keep the weight off. I also used the fact that I had PCOS (Poly
Cystic Ovarian Syndrome), which makes a woman insulin resistant and makes
it harder to lose weight than a woman that doesn't have it.
— Kristy
October 8, 2009
I agree with the first response. Make sure your doctors office has
everything that is needed. I was approved in one week. Good Luck!
— DonnaRo
October 8, 2009
I got an answer within about a week and a half with all the info from above
submitted correctly by my surgeon to BCBS
— Crissy G.
October 8, 2009
took me 4 days to get approved after everything was submited! I was
shocked!
— stephturpin
October 8, 2009
It look BS of CA about a week to approve my surgery. My surgeon is a
Center of Excellence and her office staff are extremely organized. I've
got surgery scheduled in 13 days!! Whoo Hoo!!!!!
— looking4ward
October 8, 2009
As the others have mentioned....My surgeons office kicks b*** and we had
all the paperwork together and approval was about 6 days cuz of a holiday
in there...Surgery was next available which was within 2 weeks, only
because my surgeon works out of 2 hospitals and the one I picked he only
works at 1 X per week. In other words, it was all pretty fast and feel
free to call the insurance directly for any answers
— Banded7-27-09
October 8, 2009
The first Dr. that processed my request I got approved right then as they
did it online. I had to change Dr's. and they did it online and it was
rejected so they had to send the paperwork into BC/BS it took about a
month. I called just about every other day, no one told me that the review
board only meet twice a week. I just got my approval yesterday and my
surgery is Oct. 19, I am so excited. Just hang in there it will be worth
the weight
— Sherry B.
October 8, 2009
First you must remember that BC/BS is not a single company. Each state has
it's own BC/BS and even though they all operate as if they are one company
they are not, each is an affiliate and is independently owned and operated.
So asking a quesiton like this is very difficult. When asking a question of
BC/BS you need to list your affiliate name, i.e. BC Empire, BC Illinois,
etc. Then memebers who belong to those affiliates can answer.
BC/BS Illinois took about 10 days to approve my request once all paperwork
was filed after I had participated in their required supervised 6-month
weight loss program.
— rkurquhart
October 8, 2009
My bariatric clinic really had all their ducks in a row as far as my
testing, history, etc. I was told it would be about a month but it was
actually only about 3 days before my surgeon knew since everything was
perfect before it was faxed in. The official approval letter came in the
mail after about a week.
— snickersblk
October 9, 2009
It also depends on what you had done. If it was a VSG, forget about it.
They won't cover it.
— cydthekid50
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