May be able to have surgery, after all

So my company doesn't cover gastric bypass even with "medical necessity" that being said. my insurance gave my Representative and myself wrong information. So i am going through a "misquote" processes. If the insurance did say the surgery was COVERED...then they will have to HONOR it...so I'm still HOPING for a good turn out for myself. 

Please send good vibes my way. I do believe this will be an amazing life change. I know I still have a lot of work cut out for myself, but the surgery is a GREAT start to a new healthy life style and I am READY!!! 

great,did they send you or your surgeon office a latter saying it was covered and you were eligible if so,use it to prove your case as well

If there is nothing in writing and the Insurance rep gave a verbal to your Dr office find out when your Dr office spoke to them and have the Insurance Company pull the recordings ( most all company's record all call) I hope you get through.

Best wishes and great vibes going your way. 

That is what happened. The doc office wrote down notes from the conversation and the reference number. I received a DENIED letter. However back in March the doc office called the insurance company and they had told them YES it was covered. So the insurance is supposed to go back and review the conversation to see what transpired and if the insurance company did say it was covered. Which the Doc office said it did, because the insurance company told my doc's office all the requirements and deductibles that need to be met. AND for the last three months I have been going to see doctors, dietitians, had blood work, ultrasounds, x-ray and the insurance company paid for all that...

I'm getting hopeful again...I know they will try and put a wrench in this but I HATE that my doc office and I were told it was a GO and we did all the work for it and then they say NO...I was led to believe this could happen, yeah know? I would never have go through with all the doc visits, testing and such for NOTHING...

Has insurance paid on any if your pre-op visits so far? You could check to see if they have any EOB (estimation if benefits) on file for testing already done. It makes sense to me that if they covered your prepop required visits that they may cover the rest.Good Luck!

Yes they did...the covered the FIRST consultation visit, all the referrals for pysh. eval, Sleep Study test, Dietitian, blood work all that were prescribed by the Surgeons office :) 

Sounds like you should win this one. Good luck.

When you get an ok from insurance - get it in writing. Don't signapersvfrom doc office that indicate you are responsible for a while bill if insurance does not pay.  Get it clear in writing from your doc office how much exactly you will have to pay. 

I was a self paid person in US - my insurance did not cover WLS. But my insurance covered all testing that I needed preop . 

Even know - my insurance still does not cover WLS - but pays for all my lab work.. Since lab work is needed to determine my health and preveting illness - and preventing services are covered. 

Most insurance companies document calls that come in and some even get recorded. During the misquote process they will pull the call and listen to the information that was provided along with the information that was documented during the call in their tracking system.  If incorrect information was provided then it is possible they will provide a misquote. However since the procedure has not been done i'm not sure if it will be considered. 

good luck