Question:
Those approved by Blue Cross PPO (CA) how long between submission and approval?
I've read most of the posts on BC CA turn around time that said most one week or so and I am wondering about the start time. Is that from the time BC receives the request or from the time it is mailed? I spoke with them before I saw the surgeon and they said the surgeon needs to mail them (not fax) but that they try to turn it around "fairly quickly" but wouldn't let me pin them to exactly what "fairly quickly" meant. My surgeon's office just informed me that their attempts to fax the request for authorization was refused and they must mail it (confirming what I was told a few weeks ago). Is this how other people's process went and if so, how long did it take from the time it was mailed to approval? Thanks! — susanje (posted on December 10, 2002)
December 10, 2002
I actually have an update to this. I have POS which means that I have HMO
and PPO. I believe the mailing requirement is for HMO. For PPO, I called
Blue Cross and they said to fax it and gave me the fax numbers. I think my
surgeon was confused because I am using PPO even though he is affliated
with my medical group (HMO). So the woman at Blue Cross said to just fax
for PPO. If anyone can confirm/verify, that would be great.
— susanje
December 10, 2002
hello susan i dont know if this helps but i have bc/bs empire and it is a
ppo. i s/w the ins company today and asked how long it takes to be
approved, she advised me all the surgeon has to do is call in and give the
codes that are needed and they give a verbal conformation over the phone
for surgery appoval. but i live in NY so it might not be the same. good
luck- maureen
— Maureen A.
December 10, 2002
As with anything... its often not WHAT you know, but WHO you know. The
surgical center I went through is one on the oldest ones in So.
California... and they have a LONG relationship with Blue Cross. I was
approved very quickly because the people at the surgical center hounded
Blue Cross to get the papers approved ASAP
— Valerie H.
December 10, 2002
I have Blue Cross/Blue Shield of CA PPO and it took 6 days from my first
consult to get my approval. They were a pleasure to deal with and they also
were very easy approving my Plastic Surgery :)
— P B.
December 10, 2002
My surgeon's office submitted my paperwork for me. 8 days later I was
approved by Blue Cross of CA PPO. Hopefully your surgeon's office has
mailed your paperwork in by now!
— Jennifer A.
December 11, 2002
Okay, that sounds wierd, because my doc faxed everything in, and mailed the
originals. After they received the fax, it took less than a week for
approval. Like a month later I received the paperwork in the mail saying
it had been approved. I have BC/BS CA PPO. Did you personally call the
number on the back of your card? Call them. They were SOOO nice to me.
They told me call as often as I wanted until I got an answer. E-mail me if
you have any more questions. I hope I helped. Ann 318/287
— Ann H.
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