let me start off by saying you wasted your money by hiring Obesitylaw.com. A little insight: if your surgery is outpatient it is a Fact that you do not have to precert your stay. If your surgery becomes inpatient...then you have to call your insurance, usually your provider (doctor) does that for you if not then you have like 72 hrs to do it your self. if some how everyone for got to do it then you can simply call the precert line and try to get one to retro-active back to your hospital stay.... If you got a pre- d approved, and your clm got denied all your DOCTOR has to do is refile the clm with a copy of the PRE D letter. But it is very important that you do your ck list before your surgery to make sure you qualify.