I received a letter from my insurance company on Sat. and am not sure if approved!
I got a letter that says this: This letter is in response to your recent inquiry for predetermination of benefits for the above patient. Based on a thorough review of the medical documentation submitted, the Roux-En-Y Gastric Bypass, has been determined eligible under your current health plan. (it then goes on to discuss payment information about non-participating and participating providers) Please be aware that this is not a guarantee of payment. Upon receipt of the claim and any supporting medical documentation (i.e. operative report, physician's notes), final determination of eligibility, allowances, and disposition wil be completed. So, what do you all think this means?
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