Getting info out of insurance co.

[GADeltaDawn 14]

My surgeon posted a list of questions to ask my insurance company on her website before my first visit. Here's the problem... They won't answer any of them! They just kept telling me the surgeon has to call for the information. This is my policy, don't I have a right to this information? Anyone else have this problem and find a way to get answers? This is info that should be easily provided such as the diet requirements, tests covered, medical history required, etc. I'm getting aggravated and will have no answers when I meet with the surgeon.

Edited January 13, 2015 by GADeltaDawn

[CountryGirl5584 115]

I deal with insurances all day. You most definitely have the right to know what is going to be covered and what is not. If they are asking for cpt codes etc. you can get that from the surgeon's office. If you don't get anywhere with a regular rep demand to speak to their supervisor. Unfortunately, half of these reps don't really understand the information you are asking.

[blondiebabs 214]

I work for an insurance company that only handles chronically ill children, we never expect patients/parents to know CPT codes or even know what that means, we only require those from the providers. If ins co's are requesting that from a patient, they are just being aholes.

My insurance company actually tried to talk me out of surgery when I called for info and wouldn't tell me either, so I dug around on their website searching for different weight loss surgery terms and finally found the requirements... however the hospital did have all of the requirements for me when I got there for my first seminar because they had gotten all of my insurance info when I called and set the appointment.

[Elode 8,093]

@@GADeltaDawn Well Hopefully the Dr's office will do it for you. They should have someone in charge of finances/insurance...

[Elode 8,093]

Come to think of it I Think my office had me call too but the questions where basic like is surgery covered in my plan and the requirements for surgery..that's about it.

[BLERDgirl 6,417]

Typically the doctor's office call for this. Most have a person in charge of pre-certs. However tell the insurance rep that you are entittled to answers regarding your coverage, If they continue to refuse request a supervisor.

[shellyd88 463]

GADeltadawn hi they have to give you the info u are correct its your policy etc what u need to do is call them again don't ask a bunch of questions ask for a copy of the guidelines and requirements for this procedure u are entitled by law to a written copy if u ask they may try to just tell u to look online on their website however I found it difficult to find so I was told by my boss who is an attorney to ask or it to be mailed to me I got one in three days by mail if they get pushy tell em your computer crashed u have no internet etc u get the idea good luck

[TMG1980TMG 136]

When I called my insurance they were really helpful-- she also helped me find the exact written requirements on their website as this is not listed in my benefit book- she also told me under my preventative coverage obesity appointments and nutrition visits are covered (unlimited) for patients with BMI over 30--- Mine is 47.5 so all good there!

I have my first appointment/consultation with the surgeon tomorrow morning!

Excited and nervous all at the same time!

[fox99 19]

Yes. This same exact thing happened to me. I bet we have the same insurance company. They kept telling me my doctors office had to call for that info. I found out later that i was just getting the run around. Call back and ask for a supervisor if they refuse again. You have a right to know what it in your policy.

[loseitnow4ever 7]

My surgeon posted a list of questions to ask my insurance company on her website before my first visit. Here's the problem... They won't answer any of them! They just kept telling me the surgeon has to call for the information. This is my policy, don't I have a right to this information? Anyone else have this problem and find a way to get answers? This is info that should be easily provided such as the diet requirements, tests covered, medical history required, etc. I'm getting aggravated and will have no answers when I meet with the surgeon.

I had the same problem with my insurance. It really upset me like it did you. It's my insurance & I pay for it so why can't I have some simple questions answered. They will only talk to the doctors office. I don't feel the information should be withheld from me. If they can provide it to my surgeon than they should be able to tell me or send it to me.

[Jessica Ellison-Correa 66]

i called my insurance and asked them what my beifits were and in one phone call they aproved me for the surgery provided i complete the 6 month diet plan and get the psych eval that was all handled by the bariatric coridinater with my insurance you might want to check and see if your insurance has one