Would this idea work?

Hello all. Can anyone help? I have a insurance/billing question. You all know I've been approved and am having surgery on March 1st. Well, I will be my surgeons first Lap patient. He's been only doing open up to this point. My insurance pre-cert approval letter said "MBA has reviewed your request for preauthorization of gastric bypass surgery. The services as presented are eligible for benefit coverage under the current benefit plan". When I expressed concern to the surgeons office that lap is more expensive than open, and that I was afraid that I'd have to pay a bunch more out of my pocket, she said that the letter originally sent to them DIDNT specify what way it was going to be done. (open vs lap..this is true, I saw the letter that was sent) And she said that they use the same code when they bill it.<BR><BR> Now, my question to all of you WLS experts (and I know that there are insurance people in AMOS land too)is: SHOULD I TRUST THIS SITUATION, AND IF NOT, WHAT SHOULD I DO? GET SOMETHING IN WRITING? I have to be honest with you, even though I am an assertive person, I really feel funny about this. It's kind of like saying, I dont trust your office. I don't want to offend them. But on the other hand, they have ME sign something saying that I'm responsible if the insurance DOESN'T pay! I suppose because on the bottom of the approval letter it states "There is no guarantee of benefits until the actual claim is received and reviewed" WHATS UP WITH THAT? Basically, this letter means squat!!!!!!! LOL<BR><BR>Another question:DO YOU THINK IT WOULD BE OUT OF LINE TO ASK THE OFFICE, CONSIDERING MY INSURANCE ONLY COVERS 80%, AND CONSIDERING THAT I AM THE FIRST LAP PATIENT, THAT THEY PICK UP THE 20%? Is that too tacky? I have heard of people making deals before, and it IS his business. What do you all think? I'm hoping with 60,000+ members here, someone will be able to help! Thanks a bunch! *****GretcheeGirl*****

We greatly appreciate your interest in helping us build our Q&A database. To discourage vandals from posting garbage, however, we require people to register before posting.

You must be logged in to post an answer. Click here to log in.

×