Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Didn't get pre-auth before surgery. What are the chances Insurance will pay?



Recommended Posts

The problem is this...I made several calls to our Insurance company to let them know I was having LAP-BAND® surgery and the person said it was covered. Well, I didn't believe them. I figured the person was new, or didn't know what LAP-BAND® surgery was, so I called again a few days later to get a new person and ask the same questions. This person too said, "yes, this surgery is covered" This person was even more helpful giving the link for the pre-surgery requirements all of which I met except for the psych eval. They even gave me the link to print out the form to file with the insurance company since the doc I was using did not file with insurance and wasn't in the Blue Cross Blue Shield network. I was self pay in the amt. of $9875. which includes 3 months post op. After that he only charges $25 for fills. During the surgery he did find that I had a hernia and repaired that as well. Now that I have had the surgery, and before I have filed anything with the insurance company I find out that I was required to call in for a pre-auth for surgery. We just switched to Blue Cross from Aetna in January. Aetna didn't require pre-auth's (I had foot surgery and bladder surgery last year and never got a pre-auth, unless the doc did this for me??) So, now I am wondering if anyone has delt with this issue and what the outcome was? Any ideas on how to approach this when I file for reimbursement from the insurance company? I paid with a credit card and while I will be very disappointed if they won't cover anything...it is stll the best thing I have EVER done for myself and I would have still been a self-pay regardless.:rolleyes: My primary care physician said he will do whatever it takes to help me get this paid for as he has been treating me for the last 8 years for obesity with nothing but a yoyo effect. If you have any advice on how to approach this at time of filing I would GREATLY appreciate it! (Do you think they would even cover the hernia portion of the surgery??) THANK YOU IN ADVANCE FOR YOUR ADVICE!!:rolleyes:

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×