Not submitting to insurance until after surgery?

[Mrs.FullerRN 189]

My surgeons office told me bcbs of mi does not require prior auth so I will have my surgery and then they submit everything. Huh?? What if my insurance says no? So strange to me. Has anyone else ran into this?

[Hannah55 79]

I have Medicare, which does not require prior approval either.

[Erica2013 69]

type in BCBS in the forum search and ask those who have it

[Cupcake 801]

My surgeons office told me bcbs of mi does not require prior auth so I will have my surgery and then they submit everything. Huh?? What if my insurance says no? So strange to me. Has anyone else ran into this?

Lucky butt makes me want to switch back lol.

[antinette 19]

Why don't you just call them yourself and ask "what are the procedures or guidlines for bariatric surgery.

[Erica2013 69]

hannah ....Medicare of what state?

[dgoerlitz 96]

Call yourself. BCBS of MI is a huge company and every plan is different. It is not unusual for a patient to call themselves and then the formal authorization happen behind the scenes with the doc's office. They probably work with them on a regular basis and know what the coverage is, but I would double check myself just to be sure.

[Hannah55 79]

Michigan

[Erica2013 69]

mine is of Tennessee.....but i have to have an approval first

[marfar7 1,533]

My surgeons office told me bcbs of mi does not require prior auth so I will have my surgery and then they submit everything. Huh?? What if my insurance says no? So strange to me. Has anyone else ran into this?

Yes, I also have Medicare (Oregon) and my insurance coordinator was going to process the paperwork afterwards and send it to them. I'm 2 1/2 weeks out now. I had to sign a form with the understanding that I had to pay the fees involved if for some reason medicare won't pay for it. She also said that she's never seen Medicare not cover a slipped band to sleeve revision, they always cover it. Guess I'm lucky!

Good luck!

[NoneYa 380]

That would scare the crap out of me! I would call the number on my card and talk to them directly. You should know exactly what your part will be before you get it done. I would also want to know first hand what their pre-auth requirements and guidelines are because I wouldn't want to find out later I hadn't complied with all of them.

[Purplrose323 32]

Sounds like, from what you said, that your insurance just doesn't require authorization and what they are probably submitting is the claim for payment after surgery, not submitting for authorization. Either way, I'd call the insurance and double check. You are super lucky if no auth is needed! Good Luck!

[RebecaSparkles 247]

Please please call the number on the back of your card & ask them yourselves.

Also u can ask for an estimate of your $$$$ responsibility based on your plan.

allons-y

[sknyinside 99]

I have BCBS of AL. I am jumping through all kinds of hoops and yes, prior authorization is required for me.

[Tiny One 223]

Independence Blue Cross here & pre-auth was required.