Molly - Re: How long does it take for OS to set a surgery date?

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Molly

My OS was an out of network provider, so I needed pre-approval for

the surgery. I just had to have my primary care physician call BCBS

and give them the date of my surgery. Everything with my insurance

went very smoothly.

> Hi all,

>

> I've been reading through the posts a lot ever since I got braces

a

> few weeks ago. Congratulations to all who have made it to post-op

> status thus far. It's amazing to read everyone's stories on this

> site...

>

> Anyway, after " opening a can of whoop-ass " with the managers of

> different departments at Anthem BCBS, I finally got them to issue

the

> proper letters that my OS needs in order to move forward with

> surgery. The first is an approval of medical necessity letter,

and

> the second is a letter stating that I'm covered for the various

> surgical codes that my OS listed in his predetermination letter.

>

> My question is this: how does one get precertified for the

procedure

> and hospital stay? Anthem BCBS is telling me that all my surgeon

> needs to do is call in with my surgery date. But my surgeon's

office

> is telling me that I need a letter from Anthem that pre-certifies

> both the procedure and the hospital stay. Help!

>

> For all others that have been through this process, please let me

> know if this all sounds right. I'm kind of frustrated that my OS

> isn't letting Anthem and me know of a surgery date! I really feel

> like I'm in some sort of holding pen. All I want is to get this

over

> and done with before schools start up in September.

>

> Thanks in advance for any advice you may have.

>

> MTB