I don't think my surgeon's insurance woman is wanting to help me?

I was recently told by the UAW rep at my husband's employer that the customer service # on the back of my insurance card is the wrong #. The contract and group # are right, but the customer service # is wrong. They told me that they will be sending me a new card with the correct #s on it. When the surgeon's office submitted information to the people whose # is on the back of my card they told me that i need 12 months supervised diet. When I called the # that I was told to call by the UAW rep, they told me that 6 months supervised diet is needed but waived for me since my bmi is over 50. They gave me a providor inquiry # for my surgeon's office to call and verify benefits. This is not the same # that she had called before. I called her and told her this information and she told me that it doesn't matter what # she called as long as the group # is the same. Why did it make such a big difference in criteria then? I am afraid that she won't call the new providor inquiry # for me and I will be stuck waiting 12 months.

You may have to change surgeons.  But I would talk to the office manager  first and try to get this corrected.  There is no way you should have to wait.  Might even talk with the surgeon.  Good Luck.   

First --- have you started your diet documentation?  If not, get to the doctor TODAY and get it started.  Who knows if you'll need to do 6 months or 12 months or nothing... but it's better to have it started now rather than wait 3 months down the road until someone figures out the right answer. Second --- have you gotten IN WRITING the specific criteria that is required by your insurance company for you to get approval for insurance?  If not, get it. Call the correct number for your insurance company back and ask for it in writing.  It might take a few weeks for them to send it, but at least you'll have something in writing that you can use as a checklist to get thigns movings.    Third --- don't rely on the insurance clerk at the doctors' office for your own healthcare needs.  You need to take control and do what needs to be done for yourself.  You need to be just as educated (or more) than that woman is and know exactly what she needs to do to get things done for you.   Pam

Pam, thank you for your insight. I would love to be able to do it myself. The problem there is that the insurance company told me that they do not send out any approval codes or anything in writing. They said that they would read the criteria to me over the phone, which i did fit, and gave me a provider inquiry phone # that my provider could call to verify that it was a covered benefit for me.

Robyn - I believe it is a law (can't remember if it's state or federal) that you can receive your exact benefit coverage and requirements for coverage in writing.  You are not asking for an approval code, you're asking for an explaination of your benefits in writing.  If the insurance company won't give it to you, then go to your employer and let them know you aren't getting what you have the right to have. Remember that the squeaky wheel gets the grease. Pam