SO FRUSTRATED!

[daw3378 93]

My doctor's office called and said they have the verbal approval yesterday, and we scheduled my tenative surgery date for 6/9. They won't firm it up until they get the letter. So i called the Insurance to find out when they would be sending the letter out, and if I could get it faxed to me. They girl i talked to showed it was still pending. So i called the dr's office and left a message that i was confused. I get a message back today that they are now saying I need to notify them 6 months before Surgery to get approved, not that I have to have a medically supervised weight loss, just that I need to notify them 6 months in advance!!!!! Now, I called and checked my benefits, and the Dr also called and verified benefits, and was never told any of this, and I went on my plan website and logged in as me, and you can see below that it states nothing about a 6 month noitfication!!!! I am so Frustrated, it has been 6 months of gettting all my appointments in and getting everything ready. The coordinator at my Dr office is not giving up on pushing this through, and neither am I we are both going to call the insurance tomorrow again.....I am just to irritated, I just needed to vent!!!

Notification Requirements

Special Note Regarding Medicare

If you are enrolled in Medicare and Medicare pays benefits before the Plan, you are not required to notify us before receiving Covered Health Services.

Prior notification is required before you receive certain Covered Health Services.

You are responsible for notifying us before you receive the following Covered Health Services:

· Ambulance – non-emergent air and ground

· Clinical Trials

· Dental Services -Accident Only

● Emergency Health Services if you are admitted to a non-Network Hospital.

· Obesity Surgery

· Reconstructive Procedures

· As soon as the possibility of a transplant arises (and before the time a pre-transplantation evaluation is performed at a transplant center).