Question:
No Decision made yet... Is this a good or Bad sign?
I AM WAITING ON PRE-APPROVAL FROM BCBS OF MS. & SPOKE WITH A REP. TODAY.. I CALLED THEM TODAY TO SEE WHAT KIND OF PROGRESS WAS BEING MADE ON MY PRE-APPROVAL.. I DO HAVE AN EXLUSION IN MY POLICY.. THE LADY I SPOKE WITH SAID NO DECISION HAD BEEN MADE AS OF YET ON THIS REQUEST.. IN YOUR EXPERIENCE DO YOU THINK IS GOOD OR BAD THAT A DESCIONS HAS YET TO BE REACHED SINCE THEY RECEIVED IT NOV. 29, 2001. SHE SAID IT WOULD BE 7 TO 14 MORE DAYS. — Shala M. (posted on January 3, 2002)
January 3, 2002
Hi Shala. Altho my policy did not have an exclusion in the case of MORBID
obesity, it seems as though they would flat out deny it right away if they
were sticking to the exclusion. The delay may at least indicate that they
are considering it. My insurance did send my case to an outside review
company to determine "medical necessity" and once there, I was
approved in a very short time. Perhaps your insurance company could not
determine this and sent it out to a similar outside review agency for an
unbiased second opinion! You may be able to ask the ins if they do this. I
just got "buddy-buddy" with one of the reps at my ins and kept in
touch and she was great to me! I would have flat out asked her if it was
GOOD that it was taking so long to decide on an excluded procedure! LOL! =)
Good luck to you! Dr Warden in Biloxi/Ocean Springs did my DS 7 months
ago and I'm down 104 lbs!! Blessings,
— ChristiMNB
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