Question:
I have a surgery date but insurance company won't do pre-cert

until 60 days before surgery. Is pre-cert the same as approval? I assume this means that I will not get approval/denial until 60 days before surgery. I am hoping that since I wasn't denied right off the bat that there is a good chance I will be approved. Anyone had this problem? Alliance PPO is my insurance. Thanks for any info. I've been lurking for a while now and this is my first question. Great web site.    — Susan D. (posted on September 11, 2003)

September 11, 2003
I HAVE PERSONAL CHOICE BCBS AND THEY DID THE SAME THING TO ME. THEY WOULDNT SEND APPROVAL AT ALL TILL 60 DAYS BEFORE, THEY TOLD ME THEY DONT DO PRE-CERT, ONLY APPROVALS 60 DAYS BEFORE. IT TURNED OUT ALL ALRIGHT FOR ME! ALMOST 10 MONTHS POST OP AND DOWN 131 LBS!
   — sandrac131

September 11, 2003
I have Bc/Bs PPO Fed, they precert, meaning the surgeons office calls them and they go over a list of questions. If you "pass" they tell the surgeon to go ahead and if everything is still the same on the day of surgery they will pay. I got the go ahead but they still denied it even though everything was the same. My surgeons office said not to worry, they are resubmitting, happens a lot. Your surgeons office must work with a lot of ins. companies, if they think you will get approved try not to worry. Plus you have PPO, they are easier to deal with I have been told. Good luck!
   — TheresaC