Question:
are there any suggestions to speed up insurance approval?
I have Humana PPO, I qualify for the surgery, but my husbands employer will be changing insurance carriers this January, I know for sure that Humana will cover the surgery, the new insurance is very questionable. Would it be inappropiate for me to contact current insurance co. before my 2nd appointment with Bariactric surgeon. I have already had 1st app. with surgeon, and physc. evelaution and meeting with diatiction. Thanks for any help Jamie — Jamie W. (posted on November 7, 2003)
November 7, 2003
I had Humana Choice Care PPO and it was approved in 72 hours. Best of luck
to you. Lap RNY 10/29/03
— Elizabeth L.
November 7, 2003
I don't know about Humana but Blue Cross only took 3 weeks to approve my
surgery. It was the surgeon's office that caused all the frustrating wait.
I've heard of insurance approving within days. Others do purposely drag
their feet I guess. I'm not familiar with yours, but my guess is it's the
surgeon who won't be able to get you in before the end of the year. I
would call and ask the doctor's office and explain it's now or never. That
may cause them to put you on the cancellation list at least. There's
nothing inappropriate about contacting your insurance to find out about
their policy in regard to approval time and where your approval is at this
point. I hope it works out for you. S
— sherry hedgecock
November 7, 2003
I don't know if anything I did helped speed up the approval process but
I'll give you a quick rundown of what happened on my side. I had a high BMI
to start with, 200 lbs. over, obstructive sleep apnea, gout, and bp
starting to rise, and cholesterol levels spiking for no apparent reason, so
the co-morbidities 'helped' a great deal. Then I had 3 different doc, my
pcp, my bariatric surgeon and my endocrinologist send in seperate letters,
along with mine. In my letter I was not too wordy, but gave very definite
dates and methods and attempts to lose weight. Didn't get too preachy, just
quick facts. Plus I had proof of my eating patterns for the past year on a
daily basis and written proof of my exercise logs showing my daily exercise
routines and times. I also stated what I had done to prepare beforehand,
i.e. stopped eating sugar, stopped caffiene, carbonated beverages,
mentioned the fact that I didn't smoke or drink. It took a little less than
a month for them to say OK! If you can present them with every possible
answer, before they ask the question, it makes it difficult for them to say
"This is not enough" or "You have to show that you have been
trying..." Good luck, and hope this helps in some small way!
— track
November 8, 2003
If the surgeon gets your request submitted soon you should still be able to
make it before January. Why doesn't your surgeon submit after the 1st
appointment. Call the office and explain that you very well might not have
insurance coverage afte January 1st and see what they suggest. I'm not
sure what contacting the insurance will do until they have the request in
their hands. Then you can bug the crap out of them. On the other hand, so
they do not drag things out call now and ask about the approval process and
where it should be sent or faxed to and try and get the name of someone to
send it to so you can follow up with them. Do everything you can to make
sure it is a complete submittal with everything they want and sent to the
right place. It took 10 working days for my approval from BCBS. The norm
was 5 days but because it was over the Christmas and New Year holidays they
were closed 4 of the 10 days. So all in all it was pretty fast. Good Luck
and don't be afraid to push and make yourself a pest.
— zoedogcbr
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