Anyone Had Surgery And Afterwards Insurance Denies?

[klt507 0]

I'm scheduled for surgery on August 14th and wanted to know if anyone has good through the insurance approval process and the surgery and afterwards had a problem with the insurance backing out and being stuck with a huge bill? I have United Healthcare and I'm terrified they will do that when it's too late to go back.

Any insight would be appreciated!

[SageTracey 608]

Can they do that? Surely if they approve it and you incur a bill based on their written approval, they cannot possibly back out.

But I am in Australia so don't know how things go in America.....

[shadowsun 1]

This type of surgery needs to be pre-approved. I have Blue Cross Blue Shield and rec'd a letter of approval (letter also contained a paragraph saying they generally don't pay for skin removal post-weight loss). To verify the surgery has been pre-approved, check with your surgeon's office. You can also call the 800 number on the back of your card. Don't feel like talking to anyone? Approval can usually be obtained by going online with your insurance company and checking on your personal site.

Good luck!

[Rojasanoll 920]

Contact your doctors office.

[icestorm12132008 39]

I would hope that once an insurance company approves you for surgery they ca not back out of payment. To do so would be fraudulent and denying you a covered benifit. You could sue them if they fail to pay your claim.

[sharonk 23]

Mine says i was approved but is not a guarantee of payment meaning that if they find any of the submitted info as being false they have the right to not pay. Makes sense to me. Everything that was submitted is true so im not worried.

[klt507 0]

I would hope that this wouldn't happen, but I'd like to consider the risk before it's too late. It sounds like you get a letter of approval, not just word of mouth? Did the letter come to you or your surgeon/doctor's office? I would assume that as long as I get something in writing saying they will pay, that should be good.