Predetermination letter from Secure Health...anyone?

[brock1021 46]

Called my ins co today to get a list of my exact requirements before approval would be considered. I was told that I have to have a predetermination letter before they will give me any information. Anyone else ran into this?

Thanks!!

[jen~ ins. guru 0]

A predetermination letter is what ur doctor needs to submit to the ins company to get approval foe the surgery. Normally it includes a letter of medical necessity stating why u need the surgery and how u could benefit medically. They will also include lot of ur medical records. Its also called a PreD letter and u should ask ur doctor if they have faxed it to ur insurance company yet. Normally takes 3-5 days for them to decide if they are going to cover the surgery but could take up to two weeks. If they deny it don't get discouraged u can always request an appeal. Good luck!!

[brock1021 46]

Thanks so much for the info! Could this letter come from my surgeon or does it have to be from my primary care doc?

[jen~ ins. guru 0]

Well I work for my primary doctor so I wanted to sumbit my own approval request (I'm totally OCD lol) but my insurance company (bcbs Arkansas) said my surgeon had to sumbit it. I think normally the surgeon submits it. Don't be afraid to stay on top of ur docs to make sure they are doing what they are supposed to for u.

[brock1021 46]

Thanks again! Calling tomorrow to get this ball rolling!

[jen~ ins. guru 0]

Good deal! Good luck girl!!