Healthnet Insurance

Has anyone had experience with this company? I am waiting for approval (or denial). Also, my surgeons office (Dr. Strom, Mountainside Hospital) gave me a surgery date and wants me to complete my pre-op workup without approval for surgery. Has anyone had this experience? Thanks.

The pre-op workup - do you mean the medical evaluations that establish that you are a candidate for surgery? There are some evaluations that you must do in order to obtain insurance approval. Then after approval and prior to surgery you would need to do pre-admission testing, which would include bloodwork, ekg, and other tests. Why don't you ask the office? Did you check with your insurance company to see if you have coverage for wls or is that what you are waiting for? That would help to avoid going for exams that would be for nothing. Even though your dr has given you a date for surgery, it doesn't mean a thing. Plenty of ppl have had dates far in advance and at the last minute their hearts have been broken when they're cancelled because of insurance denials. Irene

Banding is covered by my insurance. I met their 6 month supervised diet requirements and am starting my consults (I already had my psych and nutritional). My office visit for GI was denied saying that they do not cover an eval for wls unless it tis medically necessary. I am afraid to book the EGD because I will not pay for that-the office visit I can swallow. I know the difference btwn the work ups-my pre-op bld wk etc is scheduled as well. The office said sometimes people get approval-denied the night before surgery, so I am aware of that heart breaker. I was just looking for information to see if this is how Healthnet operates. I am going to call the office and the program coordinator anyway. Thanks.

Perhaps the office forgot the diagnosis code of morbid obesity which would make it medically necessary.