| community blue |
|---|
| Insurer Policy |
community blue |
| Insurer Status | Approved after first letter (09/13/04) |
| Weeks to approval |
1 |
| Comorbidities |
High blood presure,high colesterol , thyroid and arthritis |
| Policy |
Must be medically necessary |
| Comments |
I had no problems with my insurance company. They were very prompt and even called me before I got my letter. |
| Source |
Janice M |
| Blue Cross Blue Sheild |
|---|
| Insurer Policy |
Blue Cross Blue Sheild (Empire) |
| Insurer Status | Approved after first letter |
| Surgery Type |
Laparoscopic Lap Band |
| Comorbidities |
GERD, Obesity |
| Policy |
Don't know |
| Comments |
I am very pleased with the insurance process and the prompt approval. |
| Source |
Valarie R |
| Empire Blue Cross Blue Shield |
|---|
| Insurer Policy |
Empire Blue Cross Blue Shield (Pamela M.Strahmann) |
| Insurer Status | First letter sent - still waiting (12/06/05) |
| Comorbidities |
Shortness of breath, Back pain |
| Source |
Pamela S |
| HIP |
|---|
| Insurer Policy |
HIP |
| Insurer Status | Approved after first letter (03/18/06) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
1 |
| Comorbidities |
Hypertension, Shortness of breath |
| Policy |
Must be medically necessary |
| Comments |
I didn't have to deal with my insurance company, my PCP doctor and Dr Karen Gibbs asst did all the work. They didn't give my doctors a hard time either.It took about two days to get approved. It was very quick. |
| Source |
Alexa V |
| HIP ACCESS II |
|---|
| Insurer Policy |
HIP ACCESS II (POS) |
| Insurer Status | Approved after first letter (03/06/2007) |
| Surgery Type |
Open RNY |
| Weeks to approval |
1 |
| Pre-Op BMI |
49.8 |
| Policy |
Don't know |
| Source |
Nikesha L |
| MVP |
|---|
| Insurer Policy |
MVP ( MVP select care) |
| Insurer Status | Approved after first letter (07/15/02) |
| MD-supervised programs |
1 (8 weeks) |
| Source |
Carol S |
| NEIGHBORHOOD |
|---|
| Insurer Policy |
NEIGHBORHOOD (MEDICAID) |
| Insurer Status | Approved after first letter (11/15/04) |
| MD-supervised programs |
2 (6 weeks) |
| Source |
Sandra S |
| Salvatore Napolitan o |
|---|
| Insurer Policy |
Salvatore Napolitan o (Empire Blue Crossand Blue Shie) |
| Insurer Status | First letter sent - still waiting |
| Comorbidities |
Depression, Hypercholesterolemia, Shortness of breath |
| Source |
Karen N |
| 1199 |
|---|
| Insurer Policy |
1199 |
| Insurer Status | Approved after first letter (03/08/05) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
51.0 |
| Source |
RoseAnn W |
| Insurer Policy |
1199 (members choice) |
| Insurer Status | Approved after first letter (04/09/05) |
| Source |
Virginia S |
| Insurer Policy |
1199 |
| Insurer Status | Approved after first letter (10/25/05) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Source |
Dominique B |
| Insurer Policy |
1199 (1199) |
| Insurer Status | Approved after appeal letter (1/2007) |
| Surgery Type |
Laparoscopic Lap Band |
| Comorbidities |
Stress incontinence, sciatica, asthma back pains |
| Policy |
Must be medically necessary |
| Source |
Millie R |
| Insurer Policy |
1199 |
| Insurer Status | Approved after first letter (03/03/06) |
| Pre-Op BMI |
37.9 |
| Source |
Elena B |
| Insurer Policy |
1199 (NBF) |
| Insurer Status | Approved after first letter (01/17/2006) |
| Weeks to approval |
1 |
| Comorbidities |
Arthritis, Shortness of breath |
| Policy |
Must be medically necessary |
| Comments |
I found the whole process to be nerve wrecking but at the end 1199NBF is the best and I felt they were very fair as long as all necessary documentation was in. My best advice to anyone regardless of your insurance is to PRAY! |
| Source |
Jamila S |
| 1199 Member's Choice |
|---|
| Insurer Policy |
1199 Member's Choice |
| Insurer Status | Denied after first letter (04/07/06) |
| Comorbidities |
Shortness of breath, Knee pain, Back Pain |
| Policy |
Must be medically necessary |
| Source |
Makeva F |
| 1199 National Benefit Fund |
|---|
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (12/04/99) |
| Weeks to approval |
3 |
| Pre-Op BMI |
46.4 |
| Policy |
Must be medically necessary |
| Source |
Mildred P |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (04/16/00) |
| Surgery Type |
Laparoscopic Other |
| Weeks to approval |
6 |
| Source |
Laura Y |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (10/01/00) |
| Surgery Type |
Open RNY |
| Policy |
Must be medically necessary |
| Comments |
i dont think they really stalled. i called them when all my tests were done and they said they approve any surgery that deemed medical necessary |
| Source |
Betty N |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (01/12/01) |
| Weeks to approval |
2 |
| Comorbidities |
sleep apnea, asthma, and some arthritis |
| Policy |
Don't know |
| Comments |
no problem, not at all, yes, Its the best and if your lucky to have it appreciate, because I believe they might be saving my life. |
| Source |
Diana G |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (01/06/01) |
| Source |
Alex D |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (05/18/01) |
| Source |
Nanette |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (11/02/01) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
2 |
| Pre-Op BMI |
53.2 |
| Policy |
Don't know |
| Comments |
I didnt deal much honestly. It was approved pretty quickly. |
| Source |
Angela L |
| Insurer Policy |
1199 National Benefit Fund (1199 Member's Choice) |
| Insurer Status | Approved after first letter (12/13/01) |
| Weeks to approval |
5 |
| Comorbidities |
diabetes, hypertension |
| Policy |
Must be medically necessary |
| Comments |
i never actually had to do anything. my doctor's office did it all |
| Source |
Linda J |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | First letter sent - still waiting (01/15/02) |
| MD-supervised programs |
3 (38 weeks) |
| Source |
Marina K |
| Insurer Policy |
1199 National Benefit Fund (1199) |
| Insurer Status | Approved after first letter (06/27/02) |
| Surgery Type |
Open RNY |
| Weeks to approval |
4 |
| Pre-Op BMI |
56.7 |
| MD-supervised programs |
1 (16 weeks) |
| Comorbidities |
I have several co-morbitities. high cholesterol, PCOS, knee problems, back pain, etc... |
| Comments |
It took 1199 about a month to approve the surgery. The surgeon only had to send one letter, which was great. According to her...1199 has never denied a claim with WLS. I was pleasantly surprised with 1199. |
| Source |
Kelly C |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (04/01/02) |
| Surgery Type |
Open Duodenal Switch |
| Pre-Op BMI |
43.3 |
| Source |
Adrienne F |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | First letter sent - still waiting (07/29/02) |
| Source |
Nanette V |
| Insurer Policy |
1199 National Benefit Fund (national benefit fund) |
| Insurer Status | Approved after first letter (08/27/02) |
| Surgery Type |
Open Duodenal Switch |
| Weeks to approval |
1 |
| Pre-Op BMI |
62.7 |
| Comorbidities |
sleep apnea |
| Policy |
Don't know |
| Source |
Diana C |
| Insurer Policy |
1199 National Benefit Fund (members choice) |
| Insurer Status | Approved after first letter (08/29/02) |
| Surgery Type |
Open RNY |
| Weeks to approval |
2 |
| Pre-Op BMI |
43.6 |
| Comorbidities |
back pain, asthma, knee problems |
| Comments |
really cool they ar nice, i thouht that they weren't going to aprove me. i was wrong |
| Source |
France J |
| Insurer Policy |
1199 National Benefit Fund (members choice) |
| Insurer Status | Approved after first letter (02/8/2003) |
| Surgery Type |
Open RNY |
| Pre-Op BMI |
43.8 |
| Source |
Ramonita M |
| Insurer Policy |
1199 National Benefit Fund (members choice) |
| Insurer Status | Approved after first letter (10/22/02) |
| Source |
Aliana A |
| Insurer Policy |
1199 National Benefit Fund (Toni A. Fratianni) |
| Insurer Status | Approved after first letter (12/12/03) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
2 |
| Pre-Op BMI |
60.8 |
| MD-supervised programs |
2 (60 weeks) |
| Comorbidities |
arthritis, HTN |
| Policy |
Must be medically necessary |
| Comments |
My surgeons office did all the work. |
| Source |
Toni A F |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (11/26/02) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
51.6 |
| Source |
Mary D |
| Insurer Policy |
1199 National Benefit Fund (member choice) |
| Insurer Status | Approved after first letter (01/03/03) |
| Surgery Type |
Duodenal Switch |
| Weeks to approval |
1 |
| Comorbidities |
gerd ,ble edema, |
| Policy |
Must be medically necessary |
| Comments |
1199 was quick to approve the surgery no problem at all
|
| Source |
Tracey C |
| Insurer Policy |
1199 National Benefit Fund (Advance PCS) |
| Insurer Status | Approved after first letter (01/08/03) |
| Surgery Type |
Open RNY |
| MD-supervised programs |
3 0 |
| Source |
Milagros F |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (01/13/03) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
53.3 |
| Policy |
Don't know |
| Comments |
Dr.Gorecki's office took care of everything.
Never had to deal with them! |
| Source |
Melissa M |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (01/15/03) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Pre-Op BMI |
38.9 |
| Comorbidities |
diabetes, hypertension, sleep apnea. |
| Policy |
Must be medically necessary |
| Comments |
The doctor and his staff took care of everything! |
| Source |
Jennifer J |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (01/15/03) |
| Weeks to approval |
5 |
| Pre-Op BMI |
41.2 |
| Comorbidities |
sleep apnea gerd arthritis |
| Policy |
Must be medically necessary |
| Comments |
never spoke to them dr took care of it all |
| Source |
Rose B |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (08/01/03) |
| Surgery Type |
Laparoscopic RNY |
| Weeks to approval |
2 |
| Pre-Op BMI |
48.8 |
| Comorbidities |
GERD, low back and extremity pain and discomfort, migraine headaches, stress incontinence |
| Policy |
Don't know |
| Comments |
I dont't know what it was like Dr Gorecki's office handled all transactions. |
| Source |
Tanisha R |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (02/26/03) |
| Surgery Type |
Open Other |
| Pre-Op BMI |
48.7 |
| Comorbidities |
HYPERTENISON ,ASTHMA AND CHRONIC BACK PAIN |
| Policy |
Don't know |
| Source |
Amanda G |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (03/22/03) |
| Surgery Type |
Laparoscopic RNY |
| Pre-Op BMI |
51.2 |
| Source |
K B |
| Insurer Policy |
1199 National Benefit Fund (Member's Choice) |
| Insurer Status | Approved after appeal letter (10/4/04) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Weeks to approval |
6 |
| Pre-Op BMI |
56.1 |
| Comorbidities |
Sleep Apnea, Arthritis, GERD |
| Policy |
Don't know |
| Comments |
I had one set back in April, the insurance company denied me until my thyroid levels were stable, I have hypothyroidism. After that 1199 approved me in no time. |
| Source |
Yolanda S |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (04/04/03) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Weeks to approval |
1 |
| Pre-Op BMI |
43.9 |
| Comments |
1199 was great about it I called got a case worker the same day and case # as soon as the Doctors office faxed everything over . I recieved a letter saying good luck on your surgery. 1199 was just great.
|
| Source |
Edith H |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (06/10/03) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Source |
Joan R |
| Insurer Policy |
1199 National Benefit Fund (MEMBERS CHOICE) |
| Insurer Status | Approved after first letter (10/17/03) |
| Surgery Type |
Open RNY |
| Weeks to approval |
2 |
| Pre-Op BMI |
45.7 |
| MD-supervised programs |
3 (31 weeks) |
| Comorbidities |
ASTHMA, FOOT JOINT PAIN ARTHRITIS |
| Policy |
Must be medically necessary |
| Comments |
I DIDENT DO ANY THING, DR. ANGUS GROUP SENT IN MY PRE OPS , THEY ASK NO QUESTIONS JUST WANT IT MEDICALLY NECESSARY. 1199 THE BEST:)
I WOULD RECOMMEND UNION POLICYS OVER ANY OTHER'S THAT I HAVE HAD IN THE PAST. |
| Source |
Lisa T |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (08/07/03) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Source |
Tamanni |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Denied after first letter (03/25/04) |
| Surgery Type |
Laparoscopic RNY - proximal |
| Source |
Lorraine A |
| Insurer Policy |
1199 National Benefit Fund (NBF) |
| Insurer Status | Approved after first letter (03/28/04) |
| Source |
Patrice F |
| Insurer Policy |
1199 National Benefit Fund |
| Insurer Status | Approved after first letter (04/03/04) |
| Surgery Type |
Laparoscopic Lap Band |
| Pre-Op BMI |
41.3 |
| Source |
Dee |
| Insurer Policy |
1199 National Benefit Fund (keysha m montgomery) |
| Insurer Status | Approved after first letter (04/17/04) |
| Source |
Keysha M |
