Dilemma...what would you do?

I know its a bummer, but I would reschedule it. After the surgery you will have enough to deal with, why have the added stress of possibly having an enormous bill hanging over your head?

I had the same issue - and I called my insurance company and explained this to the representative. I was told it would take 15-30 days for them to review. When I told her my surgery daye (4/7), she said she would ask them to ru**** I went ahead.  I had surgery scheduled at 10am. I checked my e-mail at 7:30-8am, and there was the approval! I called her back and thanked her for rushing it, because then I could recover without the worry overhead. I was self-pay at first, then I get 90% reimbursed. Mya dvice: call and cry on the reps shoulder and ask them to please get you a response. If not, Plan B - go ahead anyway. It is worth it! :)

My predetermination letter didn't come until I was postop 2 months. I would go for it but that's me.

 Here is my two cents for what it's worth.

Ask YOURSELF how important this surgery is to you, your family, your long-term health.

If the answers are all affirmative -- then 

1) delay the surgery and wait for the approval; dealing with the recovery and life-change is challening enough without all that $$$$-related stress.

2) wait for a new surgery date pending approval.

3) if those a--holes deny you, the committ to researchng/finding an affordible self-pay option. There are lots of folks here -- incl me -- who've done so and will gladly help you in this search.  Remember, you can always take a surgery loan -- which will keep those monthly payments low.  Yes, there is interest involved, but even that extra cost -- I feel -- is worth getting surgery.

I had no patience for insurance and chose to self-pay with a loan.  And I am so glad I did. I had surgery when I wanted, where I wanted and how I wanted.  And the monlty payment is very manageable.

I also determiend that if I save $9/day on sh-t food I would othewise have eatern due to my food craziness -- then the surgery will pay for itself.  I can virtually guarantee that I am eating at least $9/day less than I was before surgery.

Just my thoughts

Edward I would have the surgery and then if the insco doe not pay, you make payments.  You might can set up a payment plan with them after the fact.  They really can't do anything to you if your making small payments to them.

As far as the money, it's less than these cars cost now a days.  Cars deprecate and your life is more important than a car :)

I know my mother in law had a hospital bill she could not pay. She just paid 10.00 a month if that was all she could pay.

If you can aford a small payment  then go for it.  I'll pray your insurance company comes through.


Good luck!

I went thru the SAME THING.

I got denied....Called in MY APPEAL
.....surgery date was set .......SELF PAID anyway...14.5K  had to have a CERTIFIED CHECK at admission FULL AMOUNT......

2 weeks AFTER  VSG ....denial overturned... won VSG  100% no copays, no deductibles

It took FOREVER for the hospital to reimburse me....long after insurance paid them!


Postpone yer surgery....it may take awhile...in event ya gotta jump that hoop ...THAT STANDARD INSURANCE DENIAL...at pre-authorization.

IT NOT WORTH IT....My surgeon is one of the best in the nation (I AM biased!!)....but to put out that kind of money...on the line for VSG...uh uh...I would not risk it.

Whats the date yer insurance gave ya...that THEY received yer paperwork...It usually 7 business days from that date.  Keep calling em...to get the status on yer case.  You can call em 10 different times and talk to 10 different people....and get 10 different answers....till ya get one that GIVES A **** ABOUT YA!!...

Keep callin em....do what ya gotta do....Many Many people self pay cuz they don't want to wait, can't wait, Head to Mexico, don't want to jump the insurance hoops, or shellin out that kinda dough means nuthin...even if they have insurance!!
 
I KNEW I was gonna get approved, so I self-paid...hey my insurance is in California ;-) 

Yer call.

As much as it pained me to do so, I decided to postpone my surgery pending my insco approval. Sucks, and I'm so pissed but it had to be done. I couldn't put myself at risk for $50K.

Thank you all for weighing in. And for your well wishes. Will keep you posted.

You asked what we would do, so here's what I would do. Doesn't mean it's right for you. I would wait. There is NO WAY my life could have absorbed the stress of having to pay for a surgery unexpectedly - but that's just me. Seems like it wouldn't hurt to wait - 15 days isn't very long. Hard to think I would risk having to pay $20K+ over waiting 2 weeks. Waiting a year? Maybe another matter. You will make the right decision for you.

I wouldn't risk it at all.  My surgery cost over $41k and that did not include the doctor's fee.  I would wait for the insurance company to give the okay and have them pay. 

T-

I have surgery next week with dr Jossart. I am paying out of pocket $12,500 for the whole thing. Maybe something to consider going to San Fran for the surgery if you don't get approved. Much less than NYC! Good Luck!