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What if? Really worried...

So I started the process back in November with my initial consultation on Nov 17th...the only reason I decided to start the process then was because I had I optimally started the process in 2015 but I had to pay 5000 out of pocket to meet deductible...so it was put off..until November when my mom brought up the subject again and instead of going to her surgeon who we suspected was out of network and that if we go in network I would pay 2500...well I found out my momma basically hit the deductible for individual and family, so I soon after scheduled my initial consultation with the surgeon of my choice. I let him know that I hit my deductible and was trying to get a December surgery date. I've met all requirements and am pretty much waiting on approval now. To stay on Track I'll be starting my preop diet tomorrow in hopes of a December 28th date. If all doesn't work out and I don't get scheduled for December and my deductible resets does any one know any actions I could take against my insurance company...I've coming cared multiple times with them and it's on record that I hit my deductible. I'm going to be pissed if I have to come out of pocket to me the deductible. TIA

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I doubt there is much you c pi ula do. How long have they had your paperwork? My insurance takes up to 15 days to decide on a request. If they respond within their time limit and your surgeon gets booked up in the mean time, while it will stink, I don't think they would be found at fault. It does stink though! I am in a similar spot and worked hard to get mine submitted and then called them several times until it was approved. My surgery is in 2 days. I wish the best for you.

Sent from my SAMSUNG-SM-G890A using the BariatricPal App

  • Author

Thank you, a lot say that my insurance usually approves within a week, I'm hoping my sleep apnea speeds up the process

Sent from my SM-G920V using the BariatricPal App

If you met all your requirements and it has been submitted to insurance already, I would suggest staying on the insurance company to get your approval. I called twice a day and also did an online chat once a day. My three contacts a day seemed to pay off because each time I contacted them they placed a new note to bump mine to the top. I received my approval in I believe two days with Cigna. Sure, they could have lied to me about the note thing lol but it seems that my constant contact helped.

  • Author

Thank you, I'm going to check in yhe next week to see if my letter was sent and then stay on top of it

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