Hello

I was told on feb 3rd i was approved for gbp and surgery is scheeuled for march 8th

But i just got a letter in the mail and it is worring me is this the approval lettet or are they saying they arent paying

Why im worried is this letter was enclosed then an appeal page

I cant seem to post a picture of the letter

But it reads

Important update enclosed

Dear provider

Based on the documentation submitter 43645 for laparoscopy gastric bypass is coverer under the members plan

However' predetermination of benefits does not guarantee payment. Benefits are always subject to other applicable requirements such as preexisting conditions limitations and exclusions payment of premium and eligibility at the time of care and services that are provided and participating and or network provider status also note some services require pre-certification

I would call ins and office but both are closed thoughts anyone elses letter look like this

GBP March 8 2017

Mine said the same exact thing and the surgeon said it's an approval. Call insurance to clarify though

Mine said the same exact thing and the surgeon said it's an approval. Call insurance to clarify though

Thank you
I got thru to MD office today referral coordinator called inaurance to ease my mind...she said yes im fact it is an approval letter but they also wanted a pre-certification for the inpt hospital stay she started it today and said she isnt worried about it at all
Didnt know they needed two approvals


GBP March 8 2017

That sounds like an approval. They add the precertification is not a guarantee of coverage as a way to CYA.