Re: Please, Please someone answer this newbies questions!!

[Guest guest]

> Hi! I have become obsessed with getting all the information on this

> surgery. I have Blue Cross Blue Shield Federal Insurance and when

I

> tried to get an address from the insurance company to send the

> approval letter I was told that they thought that because it was a

> covered surgery and out patient surgery that I did not need pre

> certification. Is there anyone out there that has this insurance

co.

> Could you let me know? Thanks Sandi Jeanes

I'm having the same problem, but in the mean time won't give approval,

maybe one of us will find a solution.

[Guest guest]

You don't need precertification with federal BC and BS. My daughter and I both

had surgery

and they paid for it. They will not cert you until you go to the hospital on the

morning of

surgery and the hospital calls and gets a number. It is in your contract that

they pay and they

do pay! Their practice of letting you know in advance has changed. You just

have to have

faith, go and have your surgery, and take the word of some of us with this

insurance...because they have paid and they do pay because it's in your contract

that they do!

You can read it in your manual which is on-line. I telephoned them and they

told me they

didn't pay. Then I found it in print...because Sue from Maine told me it was

there...and there

it was!

I know this makes you feel shakey. It did me. But they do pay. You cannot find

out anything

in advance...other than read in print that they cover gastic bypass surgery.

Flo in land

MGB 5/31/00 - courtesty of federal bc and bs (and land bc and bs too)

-60 pounds at 3 mos.

> ** Original Subject: RE: Re: Please, Please someone

answer this

newbies questions!!

> ** Original Sender: " o SETTEMBRINI "

> ** Original Date: Tue, 12 Sep 2000 20:40:18 -0600

> ** Original Message follows...

>

>

> > Hi! I have become obsessed with getting all the information on this

> > surgery. I have Blue Cross Blue Shield Federal Insurance and when

> I

> > tried to get an address from the insurance company to send the

> > approval letter I was told that they thought that because it was a

> > covered surgery and out patient surgery that I did not need pre

> > certification. Is there anyone out there that has this insurance

> co.

> > Could you let me know? Thanks Sandi Jeanes

>

>

> I'm having the same problem, but in the mean time won't give approval,

> maybe one of us will find a solution.

>

>

>

> 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

>

> and for more on the MGB,Don't miss :

> http://www.fourlane.com/mgb

>

> To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>** --------- End Original Message ----------- **

>

[Guest guest]

Hmmm After I reread this, I wondered about the wisdom of this email that I

wrote. They pay

if you qualify, I think. I think it has to be determined to be medically

necessary. I had over

100 pounds to lose and several co-morbids...so maybe that's why it was so easy.

My

daughter had over 100 to lose and no co-morbids. Both of us have federal bc and

bs and

they paid. Dr. R's info is very strong and very persuasive and it would be

difficult for them to

deny you after they see his letter. It's a big leap of faith because they don't

let you know up

front...but you can figure if you're more than 100 pounds overweight, you're

going to qualify.

> ** Original Subject: RE: Re: Please, Please someone

answer this

newbies questions!!

> **

> ** Original Date: Tue, 12 Sep 2000 21:10:58 -0600

> ** Original Message follows...

>

> You don't need precertification with federal BC and BS. My daughter and I both

had

surgery

> and they paid for it. They will not cert you until you go to the hospital on

the morning of

> surgery and the hospital calls and gets a number. It is in your contract that

they pay and

they

> do pay! Their practice of letting you know in advance has changed. You just

have to have

> faith, go and have your surgery, and take the word of some of us with this

> insurance...because they have paid and they do pay because it's in your

contract that they

do!

>

> You can read it in your manual which is on-line. I telephoned them and they

told me they

> didn't pay. Then I found it in print...because Sue from Maine told me it was

there...and

there

> it was!

>

> I know this makes you feel shakey. It did me. But they do pay. You cannot find

out

anything

> in advance...other than read in print that they cover gastic bypass surgery.

>

> Flo in land

> MGB 5/31/00 - courtesty of federal bc and bs (and land bc and bs too)

> -60 pounds at 3 mos.

>

>

> > ** Original Subject: RE: Re: Please, Please someone

answer this

> newbies questions!!

> > ** Original Sender: " o SETTEMBRINI "

> > ** Original Date: Tue, 12 Sep 2000 20:40:18 -0600

>

> > ** Original Message follows...

>

> >

> >

> > > Hi! I have become obsessed with getting all the information on this

> > > surgery. I have Blue Cross Blue Shield Federal Insurance and when

> > I

> > > tried to get an address from the insurance company to send the

> > > approval letter I was told that they thought that because it was a

> > > covered surgery and out patient surgery that I did not need pre

> > > certification. Is there anyone out there that has this insurance

> > co.

> > > Could you let me know? Thanks Sandi Jeanes

> >

> >

> > I'm having the same problem, but in the mean time won't give approval,

> > maybe one of us will find a solution.

> >

> >

> >

> > 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

> >

> > and for more on the MGB,Don't miss :

> > http://www.fourlane.com/mgb

> >

> > To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

> >

>

>

> >** --------- End Original Message ----------- **

>

> >

>

>

>

>

> 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

>

> and for more on the MGB,Don't miss :

> http://www.fourlane.com/mgb

>

> To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>** --------- End Original Message ----------- **

>