Anyone switch surgeons after their ins. approval?

[former_vbg 198]

I posted this in the Insurance forum too, but thought I might get more input by posting here too.

I was full steam ahead with a surgeon in Dallas, did all the hoops, had a surgery date set and then found out they are engaged in insurance fraud. So needless to say the brakes went on fast and hard....

I am now going through another surgeon and having to get re-approved through Aetna. They haven't changed their policy bulletin, and waiting for them to re-approve it. This Dr. is in network and such, so I would think it should be just a formality, but still worried I guess.

Anyone have to get re-approved? Had any problems? Anyone who could share their experiences or people they know would be greatly appreciated. Aetna has had my information since Monday and waiting...... Waiting once was hard enough...

[susnl 17]

Sorry to hear this. I had to switch 5 days prior to surgery because my original surgeon was no longer doing surgeries at my required Center of Excellence hospital. I spoke to Aetna and they said it was not a problem, they just needed to change the surgeon on the paperwork. However, my new surgeon was in the same practice.

I would say don't worry. If you met the medical necessity requirements once, that hasn't changed.

[former_vbg 198]

Sorry to hear this. I had to switch 5 days prior to surgery because my original surgeon was no longer doing surgeries at my required Center of Excellence hospital. I spoke to Aetna and they said it was not a problem, they just needed to change the surgeon on the paperwork. However, my new surgeon was in the same practice.

I would say don't worry. If you met the medical necessity requirements once, that hasn't changed.

Wow, that had to be a shocker. I would have thought that surgeon would have stopped taking new cases if he wasn't going to be doing surgery at that facility. Glad it worked out for you. I don't care for the woman they have doing the insurance submissions. They outsource it to some obnoxious lady who when I called to talk to her had all kinds of things wrong about what Aetna's policies were.... Then, she refused to even submit a "dummy" surgery date which helps expedite the process. Grrrrr I'm going on day #4 now...

[former_vbg 198]

Just found out that at 1:54pm my re-certification was approved. I hate that this Dr. outsources the person who does the insurance approvals. Why am I finding out first.... ????

Hoping to get a surgery date set tomorrow for the next couple of weeks. Hopefully no more surprises.... am so tired of all these hoops!!!