Question:
Blue Shield of California-Have been waiting for 3 weeks for approval
I have been waiting for 3 weeks to hear from Blue shield of Ca whether I have been approved for lap RNY. My surgeon sent all the papers over with letter from my surgeon at the end of January. Should I be waiting patiently or calling daily? I have not yet called. My doctors office has just said to be patient. Any advice? — 907leann (posted on February 19, 2006)
February 19, 2006
I worked with Medicare, so it is not your exact situation. However, I was
advised to call after 10 days and ask if they got the materials and when
was it reasonable to expect a decision. Then I called every week to 10
days. They lost the material, said my doctor had not submitted the
material requested, could not provide the letter copy although insisted
they had sent a letter, denied the claim because and then said they
probably shredded the material which they later denied, and wondered where
I got such an idea. They asked that everything be resubmitted where they
would associate it with record of my telephone calls. That was done, and
then they could not find the telephone calls.
Eventually the provider and I got on the phone together, walked them
through our steps, and goodie, goodie, they then found everything. I was
approved, and have surgery on March 16.
Now, my comments may a bit out of focus, because there was lots of work.
Don't be rude or demanding. Just call every five to 10 days, and let it be
understood that you expect appropriate action. It worked for me. As I
remember, this took almost two months. I think I wrote this up on my
profile when it was fresh on my mind. Mary-Frances Jones
— deaconj8
February 19, 2006
what else do you have to lose. call as many times as you need to. this is
for you, so if you really want you journey then you must take the bull by
the horns, remember that these people don't care about you, you need to
make the first moves.
— Steve Cohen
February 19, 2006
I had Cigna, and like the others, I was also told to be patient. After one
week, I got a letter that they hadn't recieved all the paper work they
needed and were going to close my case. I called got a # to fax to and a
name of the closet person to the fax machine! called the dr's office, had
them resend. And got approved within 24 hrs!
so..START CALLING TOMORROW 9AM!
— rmc5605
February 19, 2006
I think that at this point you should call once a day at least if you can.
Not the Doctor's office person, but your insurance...They have records of
each time you call. I am at a similar waiting point, and I call everyday.
It can be work and more frustrating. But you need to be on top of things.
At least call to make sure they are reviewing the claim, and have your
paperwork :) I will keep my fingers crossed for both of us ;)
— Kayla
February 19, 2006
Do not wait . I waited a week over the time and then when I called my drs
office found out they had overlooked faxing in all my paperwork and put my
file back up . Glad I called because they got right on it then and I had a
yes answer in 3 days . If I had called back in a week after not hearing
anything i would of had an answer and a surgery date a week sooner . Don't
put it off ! call
— losingit
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