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Need Some Advice

I Am scheduled for gastric by pass surgery July 9th ..... I have not heard back from my insurance company as far as approval ..... I do know that they cover bariatric surgery.... Does anyone if there is a better chance of me being approved since they do cover this type of surgery ..... Really nervous

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  • simply_jasz
    simply_jasz

    Just thought I'd update you girls.... My surgery was approved today ..... Went in and got my consent forms all signed and ready to go ...... Official surgery date is July 9

  • I am way to impatience to wait. I would have known the insurance persona whole family names and for all of them by now.

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My surgeons office handled the approval process then scheduled me once they had it. Have youheard from your surgeons office about the approval?

When I started I just called the insurance company and asked what the requirements were for them to cover it. They gave me a bunch but it seems like the main on was six months of consecutive weight in visits with your pcp. The. The surgeons office confirmed that is what was needed. Mine also was a high BMW with no other major health issues such as (diabetics, high blood pressure etc.) maybe yours just approved?

I had everything done & one week before surgery I was approved for surgery.

You will be approve also.

My approval took about 2 1/2 weeks to get. This all was thru my surgeons office, they have a insurance coordinator that you work with to get all your ducks in a row (tests, phys. eval., nutritional eval. etc. etc). Once you get all your requirements then they submit to insurance. At least that is the way my docotors office works it. I also had to have a letter from my regular doctor agreeing with this surgery, from what I understand this is a biggie - insurance companies like that your doctors concur on this surgery.

  • Author
My surgeons office handled the approval process then scheduled me once they had it. Have youheard from your surgeons office about the approval?

I haven't heard from them regarding the approval.... I do have an appointment tomorrow for what they call the rehearsal dinner they want to explain one last time the process to myself n a family member

  • Author
When I started I just called the insurance company and asked what the requirements were for them to cover it. They gave me a bunch but it seems like the main on was six months of consecutive weight in visits with your pcp. The. The surgeons office confirmed that is what was needed. Mine also was a high BMW with no other major health issues such as (diabetics' date=' high blood pressure etc.) maybe yours just approved?[/quote']

I know that my insurance coordinator from the surgeons office said my insurance didn't require consecutive visits to the doctor..... And I'm somewhat like yours I have a high BMW with no other major health issue ...... I guess I should just ask again tomorrow how does that portion of the process work

  • Author
I had everything done & one week before surgery I was approved for surgery.

You will be approve also.

O wow that's good to know :)

  • Author
My approval took about 2 1/2 weeks to get. This all was thru my surgeons office' date=' they have a insurance coordinator that you work with to get all your ducks in a row (tests, phys. eval., nutritional eval. etc. etc). Once you get all your requirements then they submit to insurance. At least that is the way my docotors office works it. I also had to have a letter from my regular doctor agreeing with this surgery, from what I understand this is a biggie - insurance companies like that your doctors concur on this surgery.[/quote']

Yes my surgeons office has me working with an insurance coordinator as well ..... I've finished all my pre-op exams (EKG, chest X-ray, nutritionist, psych. Eval, blood work) they didn't ask for a letter from my primary doctor though my surgeon just asked if my primary doctor was supportive and I said yes idk if maybe he contacted her on the side, they did request I bring them proof that I tried to lose the weight on my own such as a contract from the gym or a letter from weight watchers or any other weight loss programs I was enrolled in

No they just ask if your reg pcp is on board cause they will need to know you had sx and also keep up with anymeds if you are in any. Every thing medically changes. Call your insurance and see jf it was approved you should know from your surgeons off by now

I am way to impatience to wait. I would have known the insurance persona whole family names and for all of them by now.

I actually called my insurance company to make sure they had everything they needed and the rep sent an inquiry to the medical management team and asked them to expedite my request. It took two business days to get the approval. I have worked for insurance companies for several years now....sometimes they just need a push. I would definitely call and check on the approval!

  • Author
No they just ask if your reg pcp is on board cause they will need to know you had sx and also keep up with anymeds if you are in any. Every thing medically changes. Call your insurance and see jf it was approved you should know from your surgeons off by now

Yea I think I will do that ..... Because I was given my "attentive" surgery date June 5th its been two weeks already and I haven't heard back yet.

  • Author
I actually called my insurance company to make sure they had everything they needed and the rep sent an inquiry to the medical management team and asked them to expedite my request. It took two business days to get the approval. I have worked for insurance companies for several years now....sometimes they just need a push. I would definitely call and check on the approval!

Wow thank god I took your advice and called .... Come to find out no paperwork on behalf of my surgeons office has been submitted :( .... I call my surgeon and the girl tells me the insurance coordinator who was working on my case is no longer with them ..... This has me even more nervous and unhappy .... Has me thinking what if it isn't approved on time :(

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