Fear of not getting approved (blue cross blue shield of Alabama)

i am not near to submitti everything into my insurance for approval, but I keep having bad thoughts that I am doing all these pre approval tests and evaluations and what if in the end I don't get approved? I have blue cross blue shield of Alabama ( idk why it's Alabama if I live in Virginia). Anyway, can anyone tell me of their experience with bcbs of Alabama during the approval process. Did any of you guys have thoughts like this?

I have Aetna ...but  I shared the same concerns for sure.  Your doctor knows what the Insurance requires to approve your surgery. As Long as you do everythign you have to do ..you should be approved!  

Hi, Jenny, and congrats for being brave enough to start this journey! I am only 10 days post-op (sleeve), so I'm no expert yet on the surgery. However, I have worked in the medical insurance industry for the past 15 years and I can tell you this: stay involved! Do not trust your doctor's office to do everything for you. Yes. That is what they are there for, but you should know every step to prevent surprise. My suggestion is to get a small notebook and keep it with you. However you want to organize it, list all your contacts (insurance company- including benefits/pre-certification/case manager departments, your doctor, surgeon, psychologist, etc...) and all phone numbers. Record every call you make and receive: date, time, name, who they are with, phone number and summary of info discussed. Keep it with you at ALL times!!!

Start by calling the benefits number on your insurance card and find out what requirements they have for bariatric surgery. I'm sure you've already done this, but get that notebook and start right now. Knowledge is power. If you know what is required and you know you have fulfilled all the requirements before your request is submitted to insurance, you'll probably still be nervous as heck til you get the response, but you'll have greatly increased the chance your request will whizz right thru!

For example: even tho my doc's office is great, I still made sure everything was on track by calling both the doc and insurance company to make sure they were communicating as promised. A couple of times I had to call the doc and tell them insurance had not received what was sent. In this way, I prevented weeks of delay.

By staying on top of everything, which is a hurry up, wait...wait...wait, hurry up, wait...wait...wait process (for me, anyway!), insurance literally approved my surgery request in less than 24 HOURS, when their promised turnaround time is 15 DAYS.

I wish you luck and hope this helps you and/or others.

Jenny, I have BCBS Michigan (MESSA). I didn't have any problems getting approved. I was worried that maybe my BMI would be too low for them to approve me (started at 49 and surgery day was 39). But I had HBP, high cholesterol and slept with a cpap. 

I was worried about approval as well, but once submitted, I got approval the next day! My BCBS wasn't the issue, my surgeon's secretary kept telling me every month that I had to pay $1500 out of pocket before I could have the surgery. And each time she told me that, I would call BCBS and they would tell me I owe nothing! I called her and asked her to call BCBS and gave her the phone number, and she told me that she gets her information from some website tjat estumates out of pocket costs, acted like she wasn't going to call...My last monthly visit of the 6-month medical supervised requirement, she told me again about the $1500 again. At that point I was PISSED! I got BCBS on the phone and handed it to her. She went back and forth and then hung up and said I don't owe anything. You don't need that kind of drama and you don't need to ne worrying about whether or not you have to pay unexpectedly, after surgery.

Make sure you ask your doctor office if you are going to have any out of pocket costs and verify that with your insurance company. Don't take your doctor's office word for it. And also get all your paperwork and requirements submitted as soon as you can. If your plan requires paperwork from your PCP, stay on them and make sure they get their paperwork into your surgeon asap,my PCP was my biggest hold up.

Good luck to you.

I know of a woman who had BCBS of AL and had to sue them to get them to cover the DS even though they approved her for RNY.  They seem to hold things on the experimental status way longer than anyone else.  This was nearly 8 years ago, so hopefully they got their act together by now.

I live in MD and I have BCBS and I am actually gettting a revision surgery band to sleeve and I still have to go through all those darn test. I also was thinking the same think, I hope all goes well. Positive thoughts from both of us from here on out. How many more test do you have to complete Jenny J.

I have BCBS Alabama.  Had my surgery 10/27/14.  I had high blood pressure, high cholesterol, GERD and was 100 lbs overweight.  They approved me but not before I had to submit nt first born child!  My real problem was my first Dr in Austin TX.  they gave me piecemeal info as to what was required.   I think they just weren't used to dealing with the AL arm of BCBS.  Every time I thought I hd completed everything, something else had to be done.  The las thing they told me was 6 with ins with another doctor every single month.  So put off for another 6 months.  The great news - after that approved with NO PROBLEMS.  In fact, the only out of pocket money was $261 to my surgeon and $250 to hospital.  Worth it in the end, but took a while.  Great success to you.  So excited for you.

I have BCBS of Michigan.. I too had the thoughts and fears of doing it all for nothing. I had to do 6 months supervised weight loss, see the nutritionist 3 times, have a fitness evaluation done, see the surgeon multiple times... tons of stuff, tons of appts.. (1hr 15min drive one way/ 2.5 hours total driving each apt) I feared the worse.. That I would get all this done for nothing.. Well it was all for something.. It all went through with NO problems and had my surgery 5 months ago.. Just keep going and dont stop, it will all work out :)