Horror Stories

I have read a few horror stories where people get approved for a surgery / revision but then after they have it done the insurance refuses to pay for some reason for another. This freaks me out! Any advice on what to be clear of before hand in order to help decrease the chances of this happening?

Mandy

Make sure you get the letter from your ins co saying you have been approved.  YOU keep the hard  copy, don't depend on your MD office to just tell you that you are approved, you keep hard copies of everything.

Thanks for the reply MidwesternGirl....its been pretty much a consensus on all the boards to get it in writing. I really hate dealing with insurance companies and it seems like you just really have to watch out for someone always looking for a loop hole. 

Just commenting on surgeries.  DS has helped me even though I am a newbie. 


Take care
Amanda

I'm sure it's different with every insurance company out there but mine, BCBS of Illinois, does not pre-approve surgery.  However, they did provide a pre-determination of benefits letter to my surgeon and hospital.  I was sent a copy as well.  You should call your insurance company and ask.  You are their true customer, not your doctor or hospital.  They have to give you an answer to this question(s).  I would ask for written documentation of their medical policy governing weight loss surgery.  My insurance company actually makes this information available online on their website.  Yours may too.

I have been working in the medical field now for over 15 years and all I can say is get your own copies of everything.  If you have any questions before surgeon, question them and have another copy or letter confirming your conversation with them again. 

Working for dr's trying to get authorization for surgeries, we used to write down every time, number, and name we called to get the information.  Now i am truly my own patient advocate and I do not trust even dr's offices to do things on my behalf.  I do everything myself, get copies, keep copies of everything!