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Insurance reimburse me?

I am still waiting on my denial to be over turned, If I go ahead and pay out of pocket for my surgery, if my insurance pays for it will they reimburse me?

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  • They won't, because the authorization date will be after your surgery. So if you have surgery on 10/1, and on 10/15 you are approved, your authorization will be something like 10/15/2015 to 12/31/201

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Doubtful, but you would need to talk to an attorney to be sure.

I doubt it.

I am still waiting on my denial to be over turned, If I go ahead and pay out of pocket for my surgery, if my insurance pays for it will they reimburse me?

Probably not. Unless you have it in writing insurance will not reimburse.

They won't, because the authorization date will be after your surgery. So if you have surgery on 10/1, and on 10/15 you are approved, your authorization will be something like 10/15/2015 to 12/31/2015.

I wouldn't do anything until you have that authorization in hand.

And even if they do reimburse you. It would only be their normal reasonable payment. Which tends to be 30% of what a doctor and hospital actually charge. Wait.

My charges were $42k for hospital. Insurance paid $4800

The surgeon was $20k and insurance paid $4200.

Anesthesia was $3800 and they paid 100%

  • 2 weeks later...

Nope. And it's really important you don't do this. Once you've had the surgery, no one has any incentive to get the insurance to approve; the hospital, etc, will just be trying to get it from you. You have to have that approval *before* you have the surgery.

  • 2 weeks later...

most insurances will only pay for one weight loss surgery per life time so even if you have it with out it they might not cover it anyway

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