Question:
Has anyone tried to get WLS approved by POMCO?

I called them and it seems you need a soecond opinion or some kind of waiver? They gave me a speciall 800 number to get approval. Any experiences with them at all?    — Stephanie H. (posted on August 15, 1999)


November 24, 1999
It has been so long, that I am able to answer my own question! POMCO seems to be one of the more trouble-free insurance carriers to deal with. I had my initial consultation with the surgeon on 10/6 and was approved by them by 10/22 - it took a while to get them the paperwork they needed, but once they got it, I was approved in a few days. It seems that they only needed a letter of necessity from the surgeon - not all the results from the pre-op tests. I had to get the endoscopy approved also prior to getting it, but that was no big deal. My surgery is scheduled for 12/13/99, so once I find out about how they are at actually paying the bills, I will post again.
   — Stephanie H.

February 7, 2000
Me again, answerng my own questions! So far, Pomco has paid most if not all pre-op testing costs and this weekend I got the best news yet. Pomco paid my hospital - Mt. Sinai in NYC - and they accepted what Pomco paid them and as far as I know I am not responsible for the difference because they have a contract with Mt. Sinai! Next is the surgeon's bill - I will post when that comes thru.
   — Stephanie H.




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