Question:
Will they cancel my surgery if my insurance doesn't approve?

I have been scheduled for surgery on 5/21/03. All my pre-op appointments have been denied by my insurance (BCBS NH HMO) due to my hospital being out of network. I have tried appealing but that didn't help. Beth Isreal hasn't billed me yet.(I got denials 3 months ago) Thankfully the hospital seems to care more about giving their services than getting their money. When I went to my surgeon consult they said they would apply for approval and then call me to schedule a date. When the surgeon's office called and scheduled I asked if they got insurance approval and they said they're in the process. I voiced my concerns to the surgeon assistant and she said that they would send medical documents and let them take care of this. It's not as if surgery is excluded from my insurance plan...I'm just scared that I'm gonna get all excited and then 2 days before they're gonna tell me BCBS is denying for the same out of network reason. Has anyone been through this? I know someone who went through a similar situation but they got the insurance approval first before they scheduled surgery. Any input would be appreicated. Thanks a bunch :)    — mzcath (posted on April 17, 2003)

April 17, 2003
Is your surgeon the only one in your area who performs WLS and is also in your network? Sometimes, if that's the case, they'll approve the hospital even if it's out of network. Also, if there isn't a hospital near you with a WLS surgeon, they might approve. Some hospitals don't allow any WLS, so if the only in-network hospital near you is like that, it might be another way to get insurance approval to go out of network.
   — garw