Question:
surgeons office called and said that they were trying to get me

PRE-APPROVED before my consult in 2 weeks. They said the pre-approval was denied and they want to cancel my appointment. I am devastated. I told her that I have recently been diagnosed with sleep apnea and that my other co-morbids have worsened so she offered to look at updated medical records and resubmit. Why are they submitting info to the insurance company without seeing me first?    — pamela B. (posted on October 2, 2003)

October 2, 2003
Good question...call them and ask!
   — [Deactivated Member]

October 2, 2003
Hi. It sounds to me like your surgeon's office is interested in focusing on people who can get approval without any hassle. There is an extremely busy surgeon in my area who sent out a "pre-consult" form that said basically "Here is what your ins requires for all patients. If you don't have it all done we're canceling you appointment". I'd suggest visiting the "Find a Doc" section of this site. Email patients of other surgeons in your area and ask how helpful each one was concerning insurance issues. Good luck to you! (Kimberly - POSTOP Lap RNY - 1 week)
   — Kimberly S.

October 2, 2003
You know that is a good question and I have been wondering the same thing with my surgeons office as well. I havent even met with the surgeon yet and they are already trying to get me approved. They even said they DID NOT need a letter from my PCP. Well how in the heck do they know all the comorbs etc without a written history from the regular doc. HMMMMM......It all seems crazy to me. If you find out some info on everything then let me know as well. Thanks and Good Luck. God Bless you.
   — CARLA C.

October 2, 2003
My personal opinion.... money money money. I called 2 Dr's in MD before I found my Doc in VA. Both Maryland Doctor's wanted to do the same thing. I asked how they could determine my medical necessity without an exam and consult? I was told "if you want the surgery", they "(we)would make it medically necessary on paper". My insurance flat out told them that they needed to prove medical necessity and run tests before they would even talk to them - the surgeons told me that they couldn't help me unless I got pre-approved first. Funny thing... I was prepared to pay cash if the insurance didn't approve. My insurance approved with the VA Dr. once she showed medical necessity in 3 days. I felt the MD Doc's were not looking out for my health. Moooooo - To me thier office sounded like cattle markets, not Dr offices. I hope you find a good surgeon who will talk to you first like mine did. Best wishes -
   — M B.