Question:
Insurance co requested more information again, Does it look good or bad?

Ok I started my journey on Aug 28th with my consultation with my surgeon. Since I have a PPO plan I didn't have to have a referral for the appointment. Anyway my surgery request was sent in on Sept. 27th and on Sept. 30th they had already reviewed it and requested more information. They needed my medical history, a physical, all treatments tried and failed and documentation of co-morbid conditions. So I seen a doctor for the physical and had everything sent in yet again on Oct. 9th. On Oct. 13th it was reviewed again and now they want The specific CPT code for service requested; the members co-morbid conditions and treatment for them; Documentation from mult disciplinary team; and Progress notes. Does this sound like I will get an approval after these things are sent in or will they likely need even more information once this is reviewed? All opinions are appreciated. TIA,    — Marjorie F. (posted on October 14, 2002)


October 14, 2002
I was ask for additional info from my ins co. They wanted a letter from my pcp and a pschy eval. After I sent it in I received approval after 48 hrs. Good luck, and dont give up ! As long as they are asking for info they havent said NO.
   — Sher-ree S.

October 14, 2002
I agree with Sher-ree, as long as you have them asking questions, this is a GOOD sign. My insurance company asked me a couple of times for additional documentation, and I'd send it in ASAP. After I got their attention I finally got an approval, it was just tiresome trying to get to the right person to help me. Sounds like you are going to get lucky, so be ready for that phone call :)
   — Lynda T.

October 15, 2002
Ditto to the others comments. It couldl go either way. My insurance also asked for additional information and a thyroid test (which my PCP had already done, so he just sent in the info). A couple weeks later (it seemed like an eternity to me) I was approved. Remember, at this point you're not dealing with the company, it's the individual who is reviewing your paperwork. They don't all think alike, so you never know. Keep your chin and your spirits up. Even if it's denied, many people get approved on appeal.
   — Arlene S.




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