Question:
bc/bs denied me saying that i did not have a psych eval after psych eval was faxed 2

times last week. Luckily they called my doctors office about another patient and my doctors office had asked about me because i have been bothering them. they said my case was closed and i was denied because i did not have a psych eval when i did. so they took it to a supervisor and she agreed that it was a psych eval and reopened the case that day. I do not need preapproval for surgery as long as i meet criteria which i do but my surgeon office needs a letter from insurance company saying wls is a covered benefit. I am on my seventh week of waiting. Do you think i will get the letter i need? I have the benefit rep at my husbands work calling his contacts at bcbs which i found out is the boss of the boss of the woman who said i was denied and requested the psych eval 2 times. Do you think that by having the benefit rep call it will speed things up? He asked for the surgeons name and fax number. All responses will be greatly appreciated. Thank you    — wanda C. (posted on May 6, 2002)

May 6, 2002
First of all, I would personally, fax this same woman the psych eval. I would call her right before faxing it, tell her to stand by the machine, AND...send a return reciept requested form that you make up. Have her sign it and send it back immediately. I too had them say that they didn't recieve my info. This is EXACTLY what I did. When someone knows that you know their name, and that they can't deny getting the fax, it helps. Good luck to you.
   — Barbara H.