Anyone with Excellus BCBS approved? How long?

I have Excellus BCBS (formerly BCBS of CNY). My paper work was faxed to them June 9th. I haven't heard anything back yet. I'm a little concerned, however, because in doing a little more research, I read that Excellus BCBS does not pre-approve but will cover the surgery (Lap RNY) if it is medically necessesary. What exactly does that mean? Do I have to pay and then they will reimburse me?

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