Received a letter I think I am approved But not sure!!

angie48072
on 2/5/06 7:54 am - Clinton Township, MI
Hello Please read and help me : I received a letter that says: We have completed our review of your request for coverage of Gastric restrictive procedure under (employer name) benefit plan. Based on the information reviewed, we are pleased to inform you that coverage is available. ........ ect.... Then the letter tells me about charges being subject to screening and the last paragraph is a clause that the letter is not a guarantee of payment. Benefit payment is based on the provisions of the benefit plan and is subject to the guidelines, plan design, and policies effective at the time of service. OK I called Amy and she said this is a approval letter so why am I having such a hard time believing this is for real and that I am actually going to have my surgery??? I should be so happy and excited and I really feel confused I am hoping after seeing the surgeon DR. Pesta tomorrow 2/6/06 for my consult that he will say yes Angela this is your approval and your surgery date is ...... I think that is going to be what helps set in my mind. Is there any united health care patients on here that know if this is what there letter said???? I was waiting on a precert and this letter does not give any type of pre cert number but I might have been expecting more than what they send At the bottom of the letter it says cc: Carl Pesta and Henry ford Hospital but the strange part that is making me doubt that this is the final approval the date at the bottom of the letter is 1/28/06 the liv lite did not call for a pre cert till 1/30/06 so I am just thinking this is just telling me that yes my company does cover the surgery ??? Help please give me some feed back?? I want to know if I should be excited. Thank you for your help Angie I will post again after my consult tomorrow.
Michele P
on 2/5/06 9:36 am
Honestly, I don't have the foggiest idea - I just wanted to say congratulations if it is an approvable and keep fighting if it isn't. We will be watching for you post. Best, Michele P
(deactivated member)
on 2/5/06 9:48 am - Roseville, MI
I just wanted to say congrats and I am so glad that you went with Liv Lite and they are being much better to you. There are a few of us out there that did have problems with Cori. I hope all goes well for you. Email me anytime. Suzanne 300/155/150
angie48072
on 2/5/06 1:05 pm - Clinton Township, MI
Thank you Suzanne I am so happy I went with Liv Lite it was the best desicion I ever could have made. I love the staff and the surgeons have such easy going and caring personality's I am so excited about my consult and to be able to know if that letter was my approval and I will get my surgery date. Thank you for your support. Angie
Tricia J
on 2/6/06 12:37 am - northern, MI
Yes that is your approval letter for surgery and they are telling you that you have the coverage on your policey and that they will pay for the procedure. The precert letter only goes to the surgeon office and the hospital. I will be praying that your appointment goes well tommorrow with Dr Pesta and that you will be having a date in no time. I like your new picture. Tricia
cbaryo
on 2/8/06 3:38 am - SE, MI
Congratulations Angie!!!! I remember the feeling of doubt and excitement! I am sure you will feel better after your consult. Cheryl
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