Who else is waiting for insurance approval?

  • Birch
  • 1 year ago

Who else is waiting for insurance approval?  How are you handling the wait? I am so excited to schedule my BR surgery, however I'm waiting on insurance approval.  My PS's office sent in all necessary paperwork last week, so I probably still have a bit of a wait.  I'm thinking positively & trying to wait patiently, and doing research to learn effective ways to make the healing process as easy as possible.  Also planning my next conversation with my PS to make sure we are on the same page as far as desired final size.  My PS is recommending removing at least 750 grams from each breast which he said would bring me to a "C-".  I am hoping for a large B or small C after the healing process is done. Who else has just started this process and is waiting for insurance approval so you can move forward with a surgery date?

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I had CIGNA, and after what seems like forever, I found out that they don't even cover BR! I was so upset. I will be switching to BCBS of North Carolina July 1. I have an appointment with my PS July 2. So another round of waiting begins, but this time I am going to call BCBS every week until I get an answer about whether I am approved or not. I looked on their website and found the criteria to have a BR done and I've met every one of them. As long as they don't think it is for cosmetic reasons and believe that it is medically necessary then I should get approved. And I can tell you, it's not for cosmetic reasons. I'm 5'3", 140 lbs., and I'm a 32 GG.
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Ya you sound like a good candidate! It should be no problem then. The doctors know how to document all the evidence. Good luck!!
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You said you qualified for all the BCBS criteria, just out of curiosity, who did the assessment for the Schnur Scale if you haven't seen your PS yet? I am in NC and have BCBS. I chose to self pay because the best plastic surgeons unfortunately don't take insurance. I did not want my procedure done in the hospital either, I wanted outpatient in the practices' operating facility. BCBS doesn't really pay attention to 32GG or bra sizes, since every manufacturer is differential. Also, have you been treated for skin integrity problems under your breasts? Have you participated in a supervised weight loss program?
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My first appointment was with an Adult Nurse Practitioner and she took all of my measurements and, although I'm trying to lose weight, I'm not overweight. I'm just trying to get back down to a size that I'm comfortable with. She also told me that, just from working with the PS and doing the Schnur Scale calculations, I would have to have more than what is required to be removed to get the results that I want.
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If you don't meet the Schnur requirement will you qualify for BCBS to cover it? The criteria I got from BCBS was two pages long and the last requirement was the Schnur. I think above you said you met every requirement.
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The Adult Nurse Practitioner that I saw back in February was able to do the Schnur calculations and, according to her, I go over the amount that needs to be removed for BCBS to pay for it.
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Great, I misread your comment. I hope all goes well for you and you get the insurance coverage. I paid out of pocket after saving for year, and it was worth every penny. I did not get to select my size, the PS told me what he thought he could do based on my body, he did ask me if he wanted me to err on the side of bigger and smaller. He explained that when a patient requests implants they can choose a size within limits, but when a patient requests a reduction he had to make the judgement once he opened up the chest. I trusted him to use his medical and artistic skills to give me what would look the best on me and I am very pleased.
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I was just approved after 6 weeks. It depends on who u have and in what state. I'm in Massachusetts with bcbs and they told me once the paperwork is submitted then its usually approved/disapproved within 48 hrs. My doctors office said not true? I don't know who held mine up so long but call your insurance co. And find out what their policy is. I think my paperwork was lost in the shuffle at dr office so I began nagging them and lo and behold I was approved a week later. So just sit tight. Also the insurance decides a minimum to take off. So your surgeon would know best what size you could end up. There are no guarantees either because sometimes they may have to leave more than you desire due to blood flow issues etc. good luck. If you are that big you shouldn't have a problem.
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I am just beginning the insurance process unfortunately. I have started seeing a chiropractor and have scheduled my annual to get a recommendation from my gyn. With a consult on July 31st, I hope for quick approval.
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I seen my PS 2 weeks ago, April 18th and today my insurance company, Arkansas BCBS told me they just recieves all the paper work from my PS, how long is the wait from here finding out a decision?? How long did y'all wait until notified?
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BCBS approved!!! The letter was put in the mail today
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Congrats!! How long did it take you to get your approval?
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so it is completely insane to call twice a day to get updates on an approval? I called this morning and spoke to the same customer service rep as I did on Monday! And I keep taking the customer service survey afterwards rating the reps Excellent, to make sure my karma is good and strong.
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I have blue cross blue shield Florida. My qusetion is, I had failed therapy sessions last year, but that was due to a car accident I had, do you think they would take that into consideration, or would I have to go through it again.
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I have bcbs Florida and I am currently going through the 6weeks of therapy. But you should speak to bcbs and talk with your doctor
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hi, I live in Florida as well is the 6 weeks of therapy required to get approved
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my PS submitted paperwork on the 4th. I've been calling every morning at 8am to check on the status. FINALLY today they said they received the paperwork and the medical records were getting reviewed. I will keep calling every morning until they make a decision! BCBS watch out for me!
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I just had a consult 2 days ago and my PS said that they will be submitting the packet to the insurance company. I really hope and pray that I get approved soon.
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Have you heard anything from your insurance company yet?
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Yes. I got approved a week later.
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Great news!! I have BCBS of Arkansas, BCBS said today my PS office sent in all the paperwork to them so praying I will hear something next week or so
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I am currently waiting on approval. I have CIGNA insurance and have heard they are difficult to get approval from. It has been six weeks since my initial consult and I am getting antsy. I called and left a message for the ANP that done my initial consult, but haven't heard anything back yet.
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I too have Cigna. I had my initial appt in January and just got my approval letter in the mail TODAY!!!
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That's great! I am so happy for you. I go to the chiropractor tomorrow and I will get my x-rays and records from them to submit to my insurance. I can't wait for the day that I get approved, I am ready to be rid of this pain.
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I also just seen my surgeon last week. He said I had a pre approval but what does that even mean? I'm patiently waiting to hear back from them. I think I have googled every thing there is to know about this procedure.
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