"Expiration Date" on insurance approval?
Most insurance companies have expiration dates. Here are some tips to make sure you have it approved.
1. Call your insurance company, they can tell you the start and end date of your precert (authorization, notification). Ask for customer service or even the precert/authorization dept. 2. Some states it is required by law to send a letter to the member, provider and facility of the approval. On that approval letter should also have the to and from dates. Ask what the criteria is, some do not send the letter until after the hospitalization. 3. The sooner you or your physician advise the insur comp you will have time to have it approved again. 4. Make sure you check with your customer service - benefits and eligibility to make sure the procedure is a "COVERED PROCEDURE" for 2017, ALSO ask "this is not an EXCLUSION under my plan FOR 2017?. It is the same question, but you are asking it two different ways. Great time to get info about your deductible and out of pocket cost while on the phone. More and likely your doctor's office will ask these questions too, but it does not hurt to follow them yourself. Make sure you get the persons name, date and time; you may need this later on if you have to dispute a charge. Also... I know sounds strange, but call 2 or 3 times. Reps may give different answers. Also ask if there is a website you can go onto, to show your benefits and/or exclusions. 4. Ask your doctor and insurance company because of the time span, there maybe additional procedures you may have to do. example: have your pre-op done again. Ask how far in advance can you do the pre-op, it varies from 2 weeks to 2 days, depending on the proc, following guidelines for surgery (ie: pysch eval, nutrition, etc) 5. Not sure how BCBS Texas plan works, but ask for another Pre-authorization letter with the new date span. I hope I gave you some good tips that you will be able to use, before and after the procedure. I wish you luck. OH another thing, plans change at the beginning of the year, don't be surprised if your doctors office says, I will call after the first of the year, this is very common and actually a very good idea.
