Blue Cross Blue Shield - ThinnerTimes

AThinnerSandyFor2006 · 03-25-2006, 12:35 PM

I'm wondering if anyone on this forum has had experience with Blue Cross Blue Shield. If so, I'd like to know how your experience went and how long did it take to get approval. I keep getting various answers from the reps at BC/BS everytime I call.

SDphotogrl99 · 03-25-2006, 01:46 PM

I had BC/BS ppo. I got approved but My Doctor was not covered so I had to pay for him. I paid over 13,000 for my WLS. They covered the rest. It was worth it. Do you have HMO or PPO? Is your Doctor covered?

I remember when I got the call saying that I was approved and I thought that ment it was covered. It wasn't, Oh well. I would still do it again.

Good luck

Shakiki · 03-25-2006, 03:53 PM

I work for Empire BCBS and also have insurance thru them. I'm about to go thru the authorization process myself, so I know how you feel. Honestly, from what I've heard from others I work with who've had this surgery, and from what I know personally dealing with Medical Management on an everyday basis because of my job duties, as long as you meet the medical necessity/appropriateness criteria according to your local plan's medical policy, you shouldnt have a problem. Usually the authorization process can take anywhere from 2-4 wks on average.

Hope this helped...and good luck!

AThinnerSandyFor2006 · 03-25-2006, 06:00 PM

I have a PPO plan and my dr. is in network. This whole process can be nerve racking and I hate to keep asking my surgeons office questions.

Shakiki · 03-25-2006, 06:24 PM

According to your post, ur paperwork was just submitted on the 16th... every bcbs is different, but generally Medical Management and the nurse case managers that review the records work pretty quick... I would still give them another a week based on what I know, ya know... Dont worry... it'll be ok, believe me!

AThinnerSandyFor2006 · 03-25-2006, 06:38 PM

Shakiki.....you know us up north people (NJ) hate waiting. Since you work for Empire BCBS I know you know what you are talking about. I have Horizon BCBS NJ. I'll been told they are basically the same. Thanks for the words of encouragement. I needed them right about now.

Shakiki · 03-25-2006, 06:44 PM

I totally understand how anxious you are...im a nervous reck myself, and i work for the friggin company

You're in my thoughts and I wish you the best.
Let's pray we both get approved!

AThinnerSandyFor2006 · 03-25-2006, 06:46 PM

Shakiki..I wish you the best as well. I'm sure you will get approved. Please keep me posted on how you are making out .

ready4achange · 03-26-2006, 07:27 AM

I had that and when I found out the doctors office submitted it I called the ins at least once a week. As it was they didn't approve it till like the week before surgery was scheduled. Try calling them at least once a week to bug them....
Sandy

AThinnerSandyFor2006 · 03-26-2006, 08:20 AM

Thank u for the suggestion. I will call Monday. I'm just wondering if insurance companies accept the info from the dr.'s office via fax or snail mail.