Help Please???!!!

[JillianRN 0]

:mad:

So I have already completed everything that I need to to have my Lap Band done. I assumed that I was awaiting approval by my insurance company as was my Surgeon's office. My paperwork has been submitted for 2 weeks now. I called my Insurance company which is BC/BS of Michigan, and asked for an update. They informed me that 'BCBSM does not pre-authorize bariatric surgery procedured." "As with any other covered medical service, we expect the physician to document in the clinical record indications for and medical appropriateness of the procedure." and then it went on to list the requirements. I meet each expectation. I called my Surgeon's office with the report. They were unaware that the procedure had changed for this insurance company.Being a nurse..I was not aware that a surgeon or a hospital would allow you to have a procedure without prior approval..Has this happened to anyone else? The Surgeon's office is checking into the matter today....:smile2: Any ideas?

[Fluffy_Gurl 3]

Each ins is different and it depends on how your employer has the plan set up, some plans dont require pre auth for procedures, some require pre auth for everything. I once had an ins that I had to get pre auth for immunizations for my dtr at her preventative visits.