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APPROVED

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  • 2 weeks later...
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That's great Cathee!!! Where does she live in VA? I'm in VA, and she could

come by my house anytime if she's close. I'm in Falls Church, VA (Northern

VA) so let me know! :)

~Amy.

APPROVED

I just have to let everyone know. My sister who lives in Virginia and

unfortunately does not have access to an computer just got APPROVED. (Open

RNY)Her insurance company, Sentera Family Health Care, had tried to call her

last night but she wasn't home. She received the letter today. It took a

total of 6 business days for them to decide!!!!!!!!!!!!!

Cathee

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I think you're approved but I'd call just to be sure.

Anne

BigTBull@... wrote:

> From: BigTBull@...

>

> OK guys,

> Need some help!!! Today I got a letter from my ins. co., I'm just gonna type

> what it says, see what you all get out of this:

> " We have been notified of a planned outpatient procedure for the patient

> above.

> Based on the information available to us, This letter confirms that the

> requested service identified above has been approved as meeting the member's

> contract definition of medical necessity.

> This is a determination of medical necessity only and is not a guarantee of

> payment, health care benefits, or coverage. When the service is rendered the

> patient must be eligible for benefits, and the services must be covered under

> the member's contract. The use of certain providers of care may be important

> under the contract.

> You may verify eligibility and benefit coverage by contacting the appropriate

> Customer Service Unit: the phone number can be found on the back of the

> member's identification card. Additionally, if the date of service changes

> or if inpatient hospitalization is considered necessary, please call me at

> the number listed below.

> Should you have any questions regarding this outpatient procedure, please

> contact our medical management unit.

> Sincerely,

> Utilization Management "

> Sooooooo, What would be your take of this,am I approved??????? I'm going

> crazy.

> Thanks for any help.

> Tonni

> MGB wannabe-gonnabe!!!

>

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Guest guest

Cathee,

YEA!!!!! :) Paige

>

>Reply-To: MiniGastricBypassonelist

>To: " Insurance " <INSURANCEissuesonelist>, " Insurance Help "

><ossg-helponinsurance-subscribeeGroups>,

><MiniGastricByPassonelist>

>Subject: APPROVED

>Date: Sat, 18 Mar 2000 20:24:39 -0500

>

>I just have to let everyone know. My sister who lives in Virginia and

>unfortunately does not have access to an computer just got APPROVED. (Open

>RNY)Her insurance company, Sentera Family Health Care, had tried to call

>her last night but she wasn't home. She received the letter today. It took

>a total of 6 business days for them to decide!!!!!!!!!!!!!

>

>

>Cathee

>

>

>

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  • 3 years later...

Hi all... I have been reading all the post for some time now. I started

researching this surgery last year around June. My medical group requires that

we take 5 1/2 months of classes before they will send it over to the insurance

department. I finished the classes back in December, but because I never

received my mail I had to schedule my physh eval. in January. After reading all

the post about the horror stories about the physh eval, I was afraid to take it.

But when I got there he asked,maybe, 10 questions in about 10 minutes and it

was all over. After my doctor finally received all the paperwork and faxed it

over to the insurance department, it took them a week to approve it. I got the

notice and was shocked, because I have heard that many of you have been denied

many times. I have blue shield Now I need to go to a meeting at the hospital

in San Diego on March 2. I could have gone before, but i thought I would be

going to another hospital. I see my doctor tomorrow to start all the testing

in preparation for the surgery. Pacific Bariatric in San Diego told me that the

waiting time for the lap is about 12 weeks out while the open is 4 weeks out.

I had my heart set on the lap, but I really don't want to wait that long. Has

anyone had the open? and is the scar bad?. Is it better to wait, or get it over

with? I remember reading a post of a lady named in California, who had

hers done in San Diego, Can you, , tell me what doctor you saw and your

experience dealing with that hospital. This group has been a blessing and very

knowledgeable. Thank you all and I look forward to being with you all on the

losing side.

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