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I got my approval letter from the insurance today..



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This thing is worded so tricky it makes me wonder if they will actually pay for this. It says:

We reviewed your request to cover Obesity Surgery for you. Based on the information submitted and your health benefit plan, we determined that the health care service is eligible for coverage.

Please note that payment is based on the submitted claim and the actual health care services received, the guidelines and policies in place at the time of service, and the patient's plan and eligibility when the services are received. The information in this letter does NOT guarantee payment.

Blah. I'll be glad when this is over and the claims are paid.

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I'm far from an insurnace expert but this is how I would translate the letter: We will pay for medical services that you actually receive. For example many people have hietal hernias repaired during surgery. But if if you don't have a hernia your surgeon can't bill for it just becuase he normally does. Basically the surgeon can't bill for phantom treatments. Also as of today you have insurnace and they will cover the surgery. If it takes three months before you actually have surgery and by then you have lost your coverage; they are'nt bound to pay the bill if you don't still have coverage. My letter said the same type of thing.

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