Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Hi Gloria, Stop sweating bullets.All BCBS of NC subscibers are required to have seen Dr R(AKA the referring physician)I spoke with them last week to get a deadline for my follow up call for pre-determination.I had a long discussion with the lady that handles ALL of Dr R'S.She explained their process,once they receive the request for pre-determination from the referring(Dr R)they approve it or approve it with certain conditions,or deny.She said that if I have not had my appt. with Dr R (AKA Clinic w/Dr R),they will aprove it conditonal to his approval that once having seen me,surgery is recommended. Janet > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com >To: MiniGastricBypass (AT) egroups (DOT) com >Subject: Insurance Headache >Date: Mon, 07 Aug 2000 17:04:38 -0000 > >Has any one else had a problem with BCBS of NC (PCP)state employee >plan? They are giving me a real doozy of a headache! >This morning they tell me that they are waiting for Dr. Rutledge's >office to do a physical before they will approve and give me a >precertification number? Does anyone know what this is about? My PCP >has already done my physical and faxed BCBS the info about my medical >necessity and her referral of me to Dr. Rutledge for the MGB. >Any suggestions? I would like to get this done before I have to choose >another provider in October! > > >Gloria >Sweating bullets in Chapel Hill! >BMI 62 > ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Gloria, As I underderstand it, Blue Cross State of NC has an excellent record of approval with Dr. Rutledge. You should probably call of email Dr. Rutledge's office and ask about the physical though. They probably mean the clinic, but ask Barb to be sure. Barb will need to get the pre-cert number from them, too, at least she did in my case. I believe that they will pay up as soon as they have all of the information that they need. Finding out what they need can be a real trick sometimes! Stormy > Has any one else had a problem with BCBS of NC (PCP)state employee > plan? They are giving me a real doozy of a headache! > This morning they tell me that they are waiting for Dr. Rutledge's > office to do a physical before they will approve and give me a > precertification number? Does anyone know what this is about? My PCP > has already done my physical and faxed BCBS the info about my medical > necessity and her referral of me to Dr. Rutledge for the MGB. > Any suggestions? I would like to get this done before I have to choose > another provider in October! > > > Gloria > Sweating bullets in Chapel Hill! > BMI 62 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Yes, they got his letter at the beginning of July and I have been going around in circles with them since then. Each time I call (twice a week)they give me a different reason for not being approved yet. I fix that problem and then the next time it is something else. Of course every time I call I speak with a different person. The surgery has got to be easier than this!! If you can get the ladies name and extension that helped you that would be great! I turned 50 yesterday and everyone says I look like I'm in my late 30's. But if I have many more days like today I will be looking 60 soon! Thanks.....Gloria > Gloria, > I had the same insurance company as you and had no problems getting > approved. Has Dr R sent his letter to them yet? > Maybe that is what they mean. > Let me know, in the mean time I'll call and find out the ladies name I > talked to, she was a real sweetheart! > Rosemary > MGB 7/24/00 > Insurance Headache > > > > Has any one else had a problem with BCBS of NC (PCP)state employee > > plan? They are giving me a real doozy of a headache! > > This morning they tell me that they are waiting for Dr. Rutledge's > > office to do a physical before they will approve and give me a > > precertification number? Does anyone know what this is about? My PCP > > has already done my physical and faxed BCBS the info about my medical > > necessity and her referral of me to Dr. Rutledge for the MGB. > > Any suggestions? I would like to get this done before I have to choose > > another provider in October! > > > > > > Gloria > > Sweating bullets in Chapel Hill! > > BMI 62 > > > > > > > > > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > > Please visit our web site at http://clos.net > > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > > > To Unsubscribe Send and Email to: > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 In a message dated 8/7/2000 7:58:59 PM Eastern Daylight Time, Dr_Rutledge@... writes: << So come to clinic and we do an exam. What is hard about that? >> Hey when did you start doing exam's? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 I had the same problem with BCBS of MN. I went to clinic and saw Dr. R. on July 11. I took a packet that had everything in it I thought BCBS might ask for later (a letter stating the MGB was medically necessary for me, a looonngg letter from my hubby stating all of the reasons I needed the MGB, and why MGB was the best and MOST COST EFFICIENT choice, a copy of the patient manual, and Dr. Rutledge's credentials). Debbie mailed all my stuff in, along with a letter from Dr. Rutledge stating that he had seen me on Wednesday, July 12. I had put everything in a US mail Express Mail envelope with a tracking number that was guaranteed to be delivered by 10:00 am the next day. I called my insurance company at 10:15 and was told they had just received it, and they were just sending it to the review comittee. She said I should have an answer within 2 weeks. She took my number, and promised to call as soon as she had an answer for me. She called me back the same afternoon, at 2 pm, and left me a message that I had been approved! I had my MGB last Monday, July 31, and that extra trip to Durham to make my insurance company happy was definitely worth it! So, just go to clinic, like Dr. R. says, and you'll be on your way!! Good luck! Deb in IL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Gloria, I had the same insurance company as you and had no problems getting approved. Has Dr R sent his letter to them yet? Maybe that is what they mean. Let me know, in the mean time I'll call and find out the ladies name I talked to, she was a real sweetheart! Rosemary MGB 7/24/00 Insurance Headache > Has any one else had a problem with BCBS of NC (PCP)state employee > plan? They are giving me a real doozy of a headache! > This morning they tell me that they are waiting for Dr. Rutledge's > office to do a physical before they will approve and give me a > precertification number? Does anyone know what this is about? My PCP > has already done my physical and faxed BCBS the info about my medical > necessity and her referral of me to Dr. Rutledge for the MGB. > Any suggestions? I would like to get this done before I have to choose > another provider in October! > > > Gloria > Sweating bullets in Chapel Hill! > BMI 62 > > > > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Gloria, The lady who helped me was named Patrice Lennon. She was super helpful. After I finally got her name my approval came through in less than a week! Hope you can find her! Rosemary Insurance Headache > > > > > > > Has any one else had a problem with BCBS of NC (PCP)state employee > > > plan? They are giving me a real doozy of a headache! > > > This morning they tell me that they are waiting for Dr. Rutledge's > > > office to do a physical before they will approve and give me a > > > precertification number? Does anyone know what this is about? My > PCP > > > has already done my physical and faxed BCBS the info about my > medical > > > necessity and her referral of me to Dr. Rutledge for the MGB. > > > Any suggestions? I would like to get this done before I have to > choose > > > another provider in October! > > > > > > > > > Gloria > > > Sweating bullets in Chapel Hill! > > > BMI 62 > > > > > > > > > > > > > > > This message is from the Mini-Gastric Bypass Mailing List at > Onelist.com > > > Please visit our web site at http://clos.net > > > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > > > > > To Unsubscribe Send and Email to: > > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > > > > > > > > > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Hi, > Has any one else had a problem with BCBS of NC (PCP)state employee > plan? They are giving me a real doozy of a headache! > This morning they tell me that they are waiting for Dr. Rutledge's > office to do a physical before they will approve and give me a > precertification number? So come to clinic and we do an exam. What is hard about that? RR Rutledge, M.D., F.A.C.S. The Center for Laparoscopic Obesity Surgery 4301 Ben lin Blvd. Durham, N.C. 27704 Telephone #: Fax #: Email: DrR@... ************************************************ Please Visit our Web site: http://clos.net ************************************************ Durham Regional Hospital: Also, Please consider joining the Mini-Gastric Bypass Mailing List at http://www.onelist.com MiniGastricBypass is a general discussion of the Mini-Gastric Bypass ( http://www.onelist.com/community/MiniGastricBypass ) Talk with lots of other Pre and Post Op patients and friends. Keep up to date on the latest news about the Mini-Gastric Bypass. Insurance Headache > Has any one else had a problem with BCBS of NC (PCP)state employee > plan? They are giving me a real doozy of a headache! > This morning they tell me that they are waiting for Dr. Rutledge's > office to do a physical before they will approve and give me a > precertification number? Does anyone know what this is about? My PCP > has already done my physical and faxed BCBS the info about my medical > necessity and her referral of me to Dr. Rutledge for the MGB. > Any suggestions? I would like to get this done before I have to choose > another provider in October! > > > Gloria > Sweating bullets in Chapel Hill! > BMI 62 > > > > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Gloria..... I have Blue Cross/Blue Shield (PCP) of NC and I was told basically the same thing. I have an appointment with Dr. Rutledge on the 29th of this month and I'm planning on asking him about it. So if you hear anything....please let me know and I'll do the same for you. Joni BMI 63 Gloria Dean wrote: > Has any one else had a problem with BCBS of NC (PCP)state employee > plan? They are giving me a real doozy of a headache! > This morning they tell me that they are waiting for Dr. Rutledge's > office to do a physical before they will approve and give me a > precertification number? Does anyone know what this is about? My PCP > has already done my physical and faxed BCBS the info about my medical > necessity and her referral of me to Dr. Rutledge for the MGB. > Any suggestions? I would like to get this done before I have to choose > > another provider in October! > > > Gloria > Sweating bullets in Chapel Hill! > BMI 62 > > ----------------------------------------------------------------------- > [where you set the price] > ----------------------------------------------------------------------- > This message is from the Mini-Gastric Bypass Mailing List at > Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > To Unsubscribe Send and Email to: > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Gloria, this is the same thing I was going thru with bcbs of al. Have look into, she was able to rein in bcbs of al with a couple of phone calls. Good luck to you! Dinah in Al mgb 081600 > Has any one else had a problem with BCBS of NC (PCP)state employee > plan? They are giving me a real doozy of a headache! > This morning they tell me that they are waiting for Dr. Rutledge's > office to do a physical before they will approve and give me a > precertification number? Does anyone know what this is about? My PCP > has already done my physical and faxed BCBS the info about my medical > necessity and her referral of me to Dr. Rutledge for the MGB. > Any suggestions? I would like to get this done before I have to choose > another provider in October! > > > Gloria > Sweating bullets in Chapel Hill! > BMI 62 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 Dr. Rutledge... I have the same insurance....so.....I'MA COMIN'.....I'MA COMIN'! I'll be there with bells on on the 29th of this month. Joni " Rutledge, M.D., F.A.C.S. " wrote: > Hi, > > > Has any one else had a problem with BCBS of NC (PCP)state employee > > plan? They are giving me a real doozy of a headache! > > This morning they tell me that they are waiting for Dr. Rutledge's > > office to do a physical before they will approve and give me a > > precertification number? > > So come to clinic and we do an exam. > > What is hard about that? > > RR > > Rutledge, M.D., F.A.C.S. > The Center for Laparoscopic Obesity Surgery > 4301 Ben lin Blvd. > Durham, N.C. 27704 > Telephone #: > Fax #: > Email: DrR@... > > ************************************************ > Please Visit our Web site: http://clos.net > ************************************************ > > Durham Regional Hospital: > > Also, Please consider joining the > Mini-Gastric Bypass Mailing List > at http://www.onelist.com > > MiniGastricBypass is a general discussion of the Mini-Gastric Bypass > ( http://www.onelist.com/community/MiniGastricBypass ) > > Talk with lots of other Pre and Post Op > patients and friends. > Keep up to date on the latest news about > the Mini-Gastric Bypass. > Insurance Headache > > > > Has any one else had a problem with BCBS of NC (PCP)state employee > > plan? They are giving me a real doozy of a headache! > > This morning they tell me that they are waiting for Dr. Rutledge's > > office to do a physical before they will approve and give me a > > precertification number? Does anyone know what this is about? My PCP > > > has already done my physical and faxed BCBS the info about my > medical > > necessity and her referral of me to Dr. Rutledge for the MGB. > > Any suggestions? I would like to get this done before I have to > choose > > another provider in October! > > > > > > Gloria > > Sweating bullets in Chapel Hill! > > BMI 62 > > > > > > > > > > This message is from the Mini-Gastric Bypass Mailing List at > Onelist.com > > Please visit our web site at http://clos.net > > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > > > To Unsubscribe Send and Email to: > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > > > > > > > ----------------------------------------------------------------------- > > ----------------------------------------------------------------------- > This message is from the Mini-Gastric Bypass Mailing List at > Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > To Unsubscribe Send and Email to: > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2000 Report Share Posted August 8, 2000 Thanks Joni.....I'll keep you informed. Gloria Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2000 Report Share Posted August 8, 2000 Dr. R, Thanks for responding so quickly! I attended a clinic and met with you in May (your last Saturday clinic). Do I need to meet with you again before BCBS will approve the MGB? My PCP has already done my physical and I am waiting for her records so that I can send in my packet. Thanks, Gloria > Hi, > > > Has any one else had a problem with BCBS of NC (PCP)state employee > > plan? They are giving me a real doozy of a headache! > > This morning they tell me that they are waiting for Dr. Rutledge's > > office to do a physical before they will approve and give me a > > precertification number? > > So come to clinic and we do an exam. > > What is hard about that? > > RR > > Rutledge, M.D., F.A.C.S. > The Center for Laparoscopic Obesity Surgery > 4301 Ben lin Blvd. > Durham, N.C. 27704 > Telephone #: > Fax #: > Email: DrR@c... > > ************************************************ > Please Visit our Web site: http://clos.net > ************************************************ > > Durham Regional Hospital: > > Also, Please consider joining the > Mini-Gastric Bypass Mailing List > at http://www.onelist.com > > MiniGastricBypass is a general discussion of the Mini-Gastric Bypass > ( http://www.onelist.com/community/MiniGastricBypass ) > > Talk with lots of other Pre and Post Op > patients and friends. > Keep up to date on the latest news about > the Mini-Gastric Bypass. > Insurance Headache > > > > Has any one else had a problem with BCBS of NC (PCP)state employee > > plan? They are giving me a real doozy of a headache! > > This morning they tell me that they are waiting for Dr. Rutledge's > > office to do a physical before they will approve and give me a > > precertification number? Does anyone know what this is about? My PCP > > has already done my physical and faxed BCBS the info about my medical > > necessity and her referral of me to Dr. Rutledge for the MGB. > > Any suggestions? I would like to get this done before I have to choose > > another provider in October! > > > > > > Gloria > > Sweating bullets in Chapel Hill! > > BMI 62 > > > > > > > > > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > > Please visit our web site at http://clos.net > > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > > > To Unsubscribe Send and Email to: > MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > > > > > Quote Link to comment Share on other sites More sharing options...
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