Question:
I was approved for surgery and have a date on July 20th, but when I was

reading my insurance handbook it states that I have to go through a pre hospital review (which means that I have to contact oxford health plan (my insurer) and they have to evaluate weather it is medically necessary and appropriate, how long I will have to stay in the hospital and weather there are any other appropriate healthcare alternatives. After that oxford will call me or the surgeon to let them know of their decision. It states that if a covered person does not comply with the policy's utilization review features, he or she will not be elegible for full benefits under the policy. There is also a pre-surgical review as well. For the pre surgical review, it states that I must notify them with 24 hours before my scheduled surgery so they can evaluate weather the surgery is medically necessary and appropriate and weather they will approve the proposed surgery or require a second surgical opinion regarding the need for the surgery. Ok, so If I was APPROVED for surgery, why do I have to go through all of this crap again right before my scheduled surgery? I am really getting stressed out here. I am wondering what my approval is going to pay for. I don't want to call Oxford in fear that they will change their minds and deny me.What does all of this mean??? If anyone knows anything about insurance mumbo jumbo, please let me know. Thanks    — Dawn H. (posted on July 6, 2001)

July 6, 2001
IF YOU WERE APPROVED AND YOU RECEIVED A LETTER APPROVING YOUR INSURANCE THEN THE INSURANCE COMPANY MUST HAVE ALL OF THE INFORMATION. DON'T WORRY EVERYTHING WILL BE FINE.
   — laurac82101