Help! Insurance question

I recently went and saw Dr. Bour. I was very impressed and have decided to use him. The thing is that my insurance said that I have to send a letter in to the pre-dertermanation department to see if this will be covered. I first have to pay Dr. Bour 2750. Thats alot of money to waste if I can't get approved. Help!!! I have Fortis (Premier Health Systems, Inc.). Which recently changed their name to Assurant Health. PLEASE HELP ME!

Personally, I think it is wrong for them to charge you soo much upfront if you don't know if ins. will pay or not, Are you going to be able to pay for the whole thing upfront if the ins. doesn't pay?, and are you going to be able to get your $2,750. back if they dont cover it. Every ins. co. is different about covering it, there are no gaurantees with any of them. I hope you do get covered, but be careful about your $2,750. in case you don't get covered. Also, some ins. co. deny it the first time, then they will cover it after you appeal. My Dr., Dr.Givens only required $500.00 down at the first consultation, and if ins. co. turned it down we would be refunded the $500.00. I wish you the best I know how hard it is to try and get all your ins. info. togethor. Good Luck Angela

Angela, Hello, I wanted to reply on this matter as I am a pre-op patient of Dr Bours'. I can address the $2750 with you also. I was, too say the least, not to happy about having to pay it up front either. First off, the money covers all your appts with Bour, Spearman, and the nutritionist for 2 years. It also covers all of your support group meetings that you have to attend (6 pre-op and 18 post-op). If insurance DOES cover this, it will be submitted and what insurance pays, you will get back, as I understand it. As for insurance covering the surgery, yes I do understand your concern. I had the same. I can say, from experience, Bours' office is wonderful! They will quickly return phone calls and emails and work the hardest they can to get you approved. Personally, I would call up your insurance to find out what their requirements are for approving. As with mine, I had to have a psychologist, nutritionist, and 26 week medically supervised diet. No way around it. Get what they want and do it. Also, if for any reason, you decide to leave the program, I believe, that you will get your money back minus $650-750 (approx $2000 back). That is for all of the meetings, paperwork, etc. I KNOW Eric Bour is one of the best in the nation. He approaches his patients differently than other surgeons I have met. His program is different. It has an AWESOME pre-op and post-op program. It is strict with plenty of information and support. He is a caring, intelligent, funny man that I felt a connection with when I met him. I see it this way, how much money is your life worth? How much would you end up spending on one diet after another? My life is worth it and so much more. In the end, it is YOUR decision. YOU will have to live with it. I konw I might sound baised, I just wanted you to have another point of view from a patient of Dr Bour's. Please feel free to read my journey to see what I went through. I have 2 profiles. On my second one, I have some profiles of patients of Dr Bour's, go read them, email the posties, see what they have to say: First -- http://www.obesityhelp.com/morbidobesity/profile.phtml?N=R1048867547&NoStatic=1 Second -- http://www.obesityhelp.com/morbidobesity/profile.phtml?N=L1080411398&NoStatic=1 BTW, I am having surgery with Bour on August 10th with my surgery buddy, Roxane. I am counting down the days and can not wait!!!! I hope this has helped you. And not matter what you decide and what surgeon you choose, I am here to support you through your journey. Please email me if you ever need to. Leigh Ann PS -- I lived in Marietta, right near Pumpkintown for 5 years.

Angela - I went to the seminar for dr. bour last year - they told us about the up front money - dr. bour was on my ppo plan --and my insurance company told me to absolutely not put money out prior to even meeting with the doctor or having information submitted to see what is covered. that wasn't procedure with my insurance co. i was disappointed that i wasted my time going there- yes, i heard he was good but there are doctors out there who work with your insurance and set up payment plans too. i attended a seminar for another hospital and picked a surgeon who i am very, very pleased with, whom i was able to speak with prior to starting the process for the wls. i am now awaiting surgery date. Dee