Question:
I have bcbs of ill. has anyone every got approved the first time or upon appeal ?
— Tracey S. (posted on November 25, 2002)
November 25, 2002
I have Blue Cross, Blue Shield, and was approved after 1 week. Good Luck.
— ladyroberson
November 25, 2002
I have BC/BS of IL PPO and was approved in the first week no hassle or
anything. They were wonderful to deal with.
— Lisa B.
November 25, 2002
Tmajor part of HMO approvals lies with your medical group. I have
BCBS/HMO-IL, with Northwest Community Health Partners as my medical group.
I was approved in about four hours.
— [Deactivated Member]
November 25, 2002
I have BCBS of IL PPO. I had NO problem with being approved. I did have
some difficulty due to them misquoiting my out of pocket. Besides that ..
no problems.
— Gail S.
November 25, 2002
I have BC/BS PPO - and was approved and certified without a problem. The
only thing wasy my policy required that the Dr.'s office mail in the
paperwork - not fax, then they said they would need 30-45 days to respond.
(Good news - they were back to me in less than 2 weeks!) Good Luck!
— Kelly V.
November 25, 2002
hi there! :) i have hmo illinois medical group is fox valley medicine. i
had no problems at all! :) it went so fast. i talked to my pcp over the
phone and told her what i wanted to have done, she said since its 2 days
before thanksgiving (2001), let me try for a referal for surgeon and ill
get back to you shortly after the holiday.by that saturday, i had a
referal. i was able to get in to see surgeon for first time on dec 14.
there were pre op tests to go through so there was time and scheduling for
those.all was well and i was given the ok by the surgeon that hed do the
rny on me, pcp and surgeon submitted letter to hmo and within 1 weeks time
i was approved. upon calling the hospital to schedule surgery, i was able
to have it 2 weeks from the moment i called them. wow, it was all so fast!
interestingly, i was approved to revisit my surgeon at 3 weeks post op and
then 5 weeks post op but when i needed to see him at 3 months out, i was
denied. my pcp was FURIOUS!!! she said, "you know, i dont know enough
about this and hmo doesnt realize that this is a major surgery and they
need to realize how important after care is. well, as of yet, i still
havent been able to see him again so if ever he wants any blood work or
anything checked, he just instructs pcp on what he wants done. im hoping
they will grant me with being able to see him at the 1 year mark so he can
see how ive done and so we can talk and everything. well i wish you the
best of luck! :)
— carrie M.
November 25, 2002
I have BCBS HMO IL. I got approved with no problem! If you have a good
doctor who is willing to write a letter deaming it medically necessay, that
helps allot! Good Luck!
— sue S.
November 25, 2002
I have bcbs of illinois ppo and was aprroved in 2 days for the ds. that was
april of this year and i lost 131 lbs and just had panniculectomy last week
and took off another 31 lbs and insurance covered 100%.
— Joy B.
November 25, 2002
I have BC/BS HMO, medical group Elmcare, and had no problems. The way I
understand it is your medical group has to justify it to the HMO, because
any fees the HMO doesn't pay I think the medical group has to pay. So as
long as you have a PCP who has done these referrals before they should know
what to do. I have a bmi of 53, but no real comorbidities and was approved
first try in 1 week! I didn't do a thing, it was all handled by the
doctors. good luck!
— Kristy L.
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