Insurance letter legalese translation needed please

Got my acceptance (?) letter today. Here it is...

Dear ....,

We reviewed your request to cover laparoscopic biliopancreatic diversion with duodenal switch for you. Based on the information submitted and your health benefit plan, we determined that the health care service is eligable for coverage.

The information in this letted does not guarentee payment or represent a treatment decision (those are made by your physician).

blah, blah, blah...

Sincerely,
.......

Am I approved??

 It reads like an approval. I learned they always put the stuff on the bottom even though on the top they are approving it. I believe your doctor just has to code it correctly for them to pay for it. 

Are there stipulations to your coveragee such as a 6 month supervised diet or anything of the sort?

I already did the insurance requirements...6 month diet, psych test/examination, nut & exercise consult, UGI, bloodwork, heart cath and cardiac clearance...everything but the kitchen sink!

All that was turned into ins. co last week (I checked with ins co to make sure). When I spoke with the first ins rep, all she wanted to say was "The doctor has notified us." Like I said in the earlier post..."I can notify your company that I'm have surgery but that doesn't mean your company will pay for it.

I hung up with her, called back and got someone more helpful who said I was approved and I should get the letter soon.

I am hoping it is this letter and that the letter says I am approved to get the surgery (and they will pay their portion.

w0w, looks like you'll be switched in no time - congratulations!!

It looks like an approval to me!

Back in 2000, after moving to CA, I had to take the CA bar exam, 8 years after taking the VA bar exam.  I had pretty much "formatted C:" in the interim regarding anything that didn't apply to patent law (or VA domestic relations law), and of course had not studied CA law.  While I was taking the 8 week bar review course (at night, while working full time), I was having IBS issues and a CT scan showed a suspicious cyst on my ovary.  I had to chose whether to have surgery THEN, and skip the bar exam, or wait until after the exam.  I chose to wait, and was needless to say, quite distracted during my studying, and had serious concerns about whether I was up for taking it with so little preparation (many people study full time for the exam for 2 months - I didn't study outside of the bar review class, because I didn't have time, up until the last 10 days or so).

The exam was in February.  The results came out online at 6 PM the Friday of Memorial Day weekend.  That happened to be the weekend of my 25th college reunion back east - so, by 9 PM east coast time, I was two-1/2 sheets to the wind, enjoying ****tails and wine with dinner and more booze afterwards.  At 8:50, I grabbed one of my best friends from college, who is an MD, another glass of wine, and hoisted myself up to the 4th floor of the dorm (no elevator) that they had stuck me in (I was around 275 lbs then), and logged on over the phone modem.  I had my card with my password, and when the slooooow system finally let me enter it, I got the following message:

"[MyName]'s name is on the list of people who successfully took took the February 2000 CA Bar Exam."

OK, I know I'm tipsy, but I am looking for TWO WORDS: "Congratulations" and "Passed."  Those two words are NOT in that sentence!!  I look at my friend and asked her - "I KNOW I successfully SAT through the exam - but did I pass the damned thing or not?"  We both read it multiple times - both Ivy-educated, three doctoral degrees between us - and still could not be sure.  I finally decided to believe I passed the exam and headed back downstairs for more booze.

Why can these people not READ what they wrote, and pay attention to the fact that ambiguity is NOT a good thing under the cir****tances??

Sure looks like an approval!

I was hoping it was an approval, but it was so ambigous! (Thanks Diana, I knew you'd have the right words to discribe it!)  Apparently the doctor sent in the dates of 12/5 to 12/6. Someone said they were probably "dummy dates" and I called the office and was told that he was booking into the middle of November, and that my real date would probably be about then.

I hope it is in November (thought I'd prefer October), because I want to make sure I'm out of the hospital by my sons' birthday in December! ....you know, in case (heaven forbid) there would be any complications.

Since ins approved 12/5 to 12/6, I assume once I get into the hosp and get surgery, he will ask insurance for more days? Or will I really be home the next day?

Beth,

Let me guess...UHC?  That's who I have, and that's EXACTLY how my letter read. 

I am now almost 3 months out, so yea, it's a go!! 

Congratulations!

Susan

My approval letter read the same way.  It also said I was approved for one day, I was in 6, and was covered.