Insurance Provider Changed

Hello, I started this journey back in January. I have gone thru all the requirements for the insurance provider. it was submitted by the Dr. and denied, resubmitted and approved.. YaY.  but our insurance provider  changed on Nov.1st .  Waited a while and received a letter of approval from the first insurance provider and called the surgeon, told the lady  and she said she would have to resubmit everything to the new insurance provider. Does anyone know what I need to do. I thought since the original provider approved it , then they would pay for it. has anyone else had a insurance provider change right in the middle of the process.

even if one insurance company approved it, they are not going to. Pay for it now,if your employer switched companies,because no premiums for you are being paid to the old compNy. Why would they pay for something when they don't have to. Approving it was just paperwork; unless you are an actual customer at the time of the surgery,they aren't going to pay it.

i think all you can do is submit to the new company and see what happens. Do you know for sure that your employer bought the rider for Wls with the new company?

Thanks for the reply.... I am under my wife's insurance, she is an R.N., and  I am having the surgery at the hospital where she works.  Every one that I have talked to today has said that as much money as the bariatric surgeon brings in to the hospital, that when they changed providers,  bariatric surgery is still covered and maybe easier to get approved if I have already been approved by the previous provider.   The lady that I talked to was the office manager and the lady that handles the insurance filing stuff has been out of the office all week and should be back in the office friday. After I talk to her I will post back and  I am sure everything will be fine and I am sure I will be having surgery soon. thanks so much

Bill

what have you found out?

I called the insurance provider and she told me that I was approved for the lap - band and the  RNY procedure but not the VSG procedure that I wanted. So I called the Lady at the surgeon's office and she told me that she is working on it. she told me that the provider coverage should be the same as the the previous provider and they are working out the issues. She told me that she would call me friday 11/14/14 and let me know how it's going. she asked me if I would consider  having the RNY procedure if they were unable to get the VSG approved and I told her it would be fine with me to switch to a RNY, She said she would talk to the Surgeon about it and let me know Friday. I have researched the different options and in some ways the RNY procedure may be a better choice for me  anyway , So I am Fine until Friday... Thanks  

first doesnt matter what your other insurance company approved unless you had surgery in that timeframe forget that one, this is a new contract YOU accepted when it changed over, so you have to use the contract that is in place at time of surgery. 

 so you have obesity surgery covered, but VSG they are saying no let me guess experimental?, well this is an such an easy appeal to win,  since the vsg is now a covered standard of care for obesity.  good luck on your next surgery

YaY, She called and I have been approved for a VSG Procedure. My surgery date is Dec.1st.

great news! GL

I start my post -op diet tomorrow, but i've been working on it all weekend ... I got my protein powder today... and off I go. I still have to pass the meeting with the surgeon thursday and have pre- op testing tomorrow so I still have my fingers crossed... thanks  

great. You will get. Waymore infor/ replies now,if you start posting on the VSG forum,look under forums in the blue bar above.