Questionable VSG approval from Anthem Blue Cross
Hi folks -
Really stressed out at the moment. I know I'll be able to call my surgeon and Anthem on Monday during business hours, but until then I'm feeling like I may not be getting what I've worked so hard and passionately on to achieve.
I've been traveling -
On Wenedsday (22nd), surgeon calls me to inform me that I've been approved by AnthemBC for VSG. Absolutely elated. We sent a surgery date for July 5th, and I send a cashier's check for the post-op program fee.
On Friday (25th) I called AnthemBC to ask about my copays and deductibles regarding my out-of-pocket costs, and they nicely answer all my payment and coverage questions, and act as if I am certified for the surgery.
When I returned home Saturday, I had mail from AnthemBC dated Tuesday (21st), saying my outcome was "pended", and that I would have to instead provide MD notes and exam findings, disgnostic testing results, prevoiusly tried treatments and medications, and any other information that I feel would support this request.
I know when business opens up tomorrow on Monday, I'll be able to figure out what's going on, but until then I'm stewing. Did AnthemBC tell my surgeon the wrong thing? Did my surgeon tell me the wrong thing to get my payment? Is my surgery date going to have to be a month or two away instea of next week? (due to travel obligations, this is really the only time I can have the surgery until the winter holiday.)
I just got so, so, very happy and excited when the surgeon's office told me I was fully approved and we set a date. Now I feel a bit crushed. Hard to wait for tomorrow to get some resolutions
Has anyone else had a similar experience?
Really stressed out at the moment. I know I'll be able to call my surgeon and Anthem on Monday during business hours, but until then I'm feeling like I may not be getting what I've worked so hard and passionately on to achieve.
I've been traveling -
On Wenedsday (22nd), surgeon calls me to inform me that I've been approved by AnthemBC for VSG. Absolutely elated. We sent a surgery date for July 5th, and I send a cashier's check for the post-op program fee.
On Friday (25th) I called AnthemBC to ask about my copays and deductibles regarding my out-of-pocket costs, and they nicely answer all my payment and coverage questions, and act as if I am certified for the surgery.
When I returned home Saturday, I had mail from AnthemBC dated Tuesday (21st), saying my outcome was "pended", and that I would have to instead provide MD notes and exam findings, disgnostic testing results, prevoiusly tried treatments and medications, and any other information that I feel would support this request.
I know when business opens up tomorrow on Monday, I'll be able to figure out what's going on, but until then I'm stewing. Did AnthemBC tell my surgeon the wrong thing? Did my surgeon tell me the wrong thing to get my payment? Is my surgery date going to have to be a month or two away instea of next week? (due to travel obligations, this is really the only time I can have the surgery until the winter holiday.)
I just got so, so, very happy and excited when the surgeon's office told me I was fully approved and we set a date. Now I feel a bit crushed. Hard to wait for tomorrow to get some resolutions
Has anyone else had a similar experience?
(deactivated member)
on 6/26/11 10:20 am, edited 6/26/11 10:22 am
on 6/26/11 10:20 am, edited 6/26/11 10:22 am
Hi There, I noticed you posted in the main forum about this, but you are not going to get much reponces unless you go to the VSG Board in this site.
Link Here: www.obesityhelp.com/forums/VSG/
There you might find alot more of a reply.
I hope you find what you seek. =)
Link Here: www.obesityhelp.com/forums/VSG/
There you might find alot more of a reply.
I hope you find what you seek. =)
On June 26, 2011 at 2:18 PM Pacific Time, ruggie wrote:
Hi folks -Really stressed out at the moment. I know I'll be able to call my surgeon and Anthem on Monday during business hours, but until then I'm feeling like I may not be getting what I've worked so hard and passionately on to achieve.
I've been traveling -
On Wenedsday (22nd), surgeon calls me to inform me that I've been approved by AnthemBC for VSG. Absolutely elated. We sent a surgery date for July 5th, and I send a cashier's check for the post-op program fee.
On Friday (25th) I called AnthemBC to ask about my copays and deductibles regarding my out-of-pocket costs, and they nicely answer all my payment and coverage questions, and act as if I am certified for the surgery.
When I returned home Saturday, I had mail from AnthemBC dated Tuesday (21st), saying my outcome was "pended", and that I would have to instead provide MD notes and exam findings, disgnostic testing results, prevoiusly tried treatments and medications, and any other information that I feel would support this request.
I know when business opens up tomorrow on Monday, I'll be able to figure out what's going on, but until then I'm stewing. Did AnthemBC tell my surgeon the wrong thing? Did my surgeon tell me the wrong thing to get my payment? Is my surgery date going to have to be a month or two away instea of next week? (due to travel obligations, this is really the only time I can have the surgery until the winter holiday.)
I just got so, so, very happy and excited when the surgeon's office told me I was fully approved and we set a date. Now I feel a bit crushed. Hard to wait for tomorrow to get some resolutions
Has anyone else had a similar experience?
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