X-POST Useful Medicare PA insurance nugget

JazzyOne9254
on 5/26/12 11:36 pm, edited 5/26/12 11:38 pm
In my quest for prior authorization to have excess skin removed from my thighs, I got this little nugget of information from Medicare - I'm going to check with my replacement plan to find out if it works this way with them:

If the surgery is done on an outpatient basis - insurance *cannot* be submitted for prior autthorization retroactively.  GUARANTEES non-coverage.

If the surgery is done INPATIENT - including hospital stay for at least 24 hours post op - retroactive PA can be done *up to 90 days post-procedure* They could conceivably still deny, but I'm thinking if inpatient is necessary, they would be nuts not to! If they did, you could still appeal!

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

Danae T.
on 5/29/12 12:55 am
That is great news for you. Good luck!!
    
Danae T    
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