Question:
Hi there, I just read your response to one of the questions on the internet.

Question: Have any of you ever gone ahead and had the surgery before the okay comes through although it all looks like it should? My surgery is scheduled for July 29, 1999 Please respond as soon as possible. Thanks, Jody    — [Anonymous] (posted on July 22, 1999)


July 22, 1999
No the cost is so high I would not take the risk unless I knew I had the $$$$.
   — Helen W.

July 22, 1999
Welll .. no, not in my case, however, the insurance company has the right, even if they were going to approve the surgery, to deny coverage when a pre-approval is required, UNLESS it is a true emergency. So if you were to be denied because you went thru with the surgery prior to approval, you'd have an uphill battle to prove you couldn't wait another week or couple days, you'd likely have to prove that the weight or complications thereof was going to kill you in the next 24 hours or so, in order to get them to pay. If they've mailed the letter, you could get approval over the phone to proceed, but I'd wait until I had the approval in hand or at least verbally and fully documented unless I could afford to pay for the surgery and all the surrounding expenses.
   — Sherrie G.

July 22, 1999
Without a pre-cert, you run the risk of being responsible for the entire bill plus the cost of any complications. Be careful.
   — Debbie T.




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