Confused about insurance Letter

penny F.
on 1/22/05 1:28 am - webster, WI
When I started this whole journey the hospital where I'll be having surgery had me contact the insurances I have & ask if they cover this procedure. (That was before I did ANY of the appointments like to the dietitian or counselor or anyone.) The insurance companies asked me several questions told me I seemed meet their standards so yes it would be covered. Is there something else I need to do?
KRIS E
on 1/22/05 8:21 am - Milw., WI
Hi Penny, Call your insurance co. back and ask what they require to APPROVE Gastric bypass surgery (diet history, psych-eval, letter of medical necessity, dietician consult, etc.) Your surgeon or the hosp. probably have guidelines setup to help you get everything that is needed in order to help with the approval process. The clinic where I am going to, took care of submitting everything that was needed, to my ins. co. Then from there, I waited for a letter from my ins. telling me if I was approved or not ( a copy was also sent to my surgeon) I hope this Helps. You can email me if you have any more questions. Good luck!! Chris M
Dennis T.
on 1/28/05 3:08 am - Milwaukee, WI
Hi Penny, I think you need to call your insurance company and make sure the surgery is a covered surgery with them. You may want to get Pre-approval and you will have no problems. I did the opposite (naughty me) I did all I was supposed to do to have the surgery except talk to my insurance company. Once I did, I was denied. So get pre-approval and you should be good to go. You should know that getting pre-approval you may need extensive paperwork from your PCP and a diet history and so on. Good luck. Dennis
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