Negotiations $$

[Sandy104 1]

Hi, I've been stalking (in a nice way) you all for tidbits and insights in what to expect and a time-line of events. This is my 3rd attempt to get weight loss surgery throughout my adult life. The first 2 attempts got my hopes up and then boom, insurance denied. So I work for Walmart and saw something about thier Center of Excellence and weight loss coverage and thought I'd give it another shot. So because of covid I wouldn't have to go from Cincinnati to Cleveland to have this done, which is the closest center to me. I have an exemption they call it. So they found me a dr in cincy. I have an appointment 7-16. Communication between myself and insurance is basically a new experience for me. I don't typically see drs. Or had anything major happen to me in years. I have a letter that says I have a prior authorization but they have to agree on the cost. Anyone gone through this? I want to believe it's finally going to happen yet still apprehensive.

[DoodlesMom 98]

There is an Insurance and Finance section under Forums. Dealing with insurance can be a pain in the butt. Try not to let it break your spirit or momentum. It's common to need insurance verification before starting the process. Your visits must be covered so you don't end up with surprise bills. Good luck and welcome. There are so many knowledgeable and supportive people here.

[FutureSkyDiver 76]

Never accept the first denial from insurance companies. If they deny you, appeal. It is a heck of a lot faster and cheaper for them to deny coverage than to cover something, so they do…gambling on the fact most people either don’t know they can appeal, or don’t actually do it.

[Sandy104 1]

Thanks! I guess I never really thought about appealing a denial. I have a letter from the insurance saying I have a prior authorization, they just need to agree on the price of the surgery. I haven't heard anything for 8 days. I am going to give them a few more and contact them on my next day off when I have time to play phone tag. I just never know what to say. Guess I'm going to learn. Lol.