Approved.....but a huge delay. UGH

[MrsB2007 90]

So....I went through all of the hoops and got a quick approval from insurance. Then we had to wait for about a week to actually get a paper approval in the mail (which they decided they no longer send out- just provide an approval number over the phone).. No biggie. Lets schedule a date!

Not so fast. The surgeons office called me to tell me they received the approval info, but they are in transition between hospitals that they do the surgerys from. WHAT?! Yes, they are doing surgeries from a different hospital and are in the works with coordinating how many days per week they are doing surgeries and how many per day. Then they are scheduling surgeries on a first approved basis (sounds fair). They have people from November & December who have not had surgeries yet (about 35-40 people).

Assuming they do 6 surgeries per week at this hospital (at most), That would put me at the end of Februrary or beginning of March instead of about a week after approval was receieved. I've waited this long... another month or so wont hurt, right? Well, as of March 1st I may not have insurance any longer. Awesome. ::Facepalm::

So, I decided to think of alternatitves. What if I chose a different surgeon at a different hospital? They would have to resubmit everything to insurance (which would take 2 weeks to approve-if at all) and then the preop diet etc.. I would still be looking at the same surgery dates.

[Jersrose43 837]

They don't have to resubmit. They call the jnsurance with the authorization number. The jnsurance changes the name of surgeon and hospital.

Most insurances will do that for you. You should call the carrier and find out which surgeons are in network and if it has to be at a center of excellence.

Good luck

[BeagleLover 1,020]

If you like that surgeon, I would definitely let them know the circumstances... I'll bet they'll get you in before your deadline.

[mimib 0]

I also got approval from my insurance but still have to wait another 4 months due to all the pre-requisites. My BMI just qualified me so I have to totally maintain my weight. I can't lose & I can't gain. This has me very worried!!

[Stevehud 1,790]

i was in somewhat of the same boat my approval was completed on dec 12th and because i had explained the probability of my insurance changing etc my surgery was 4 days later.

[BeagleLover 1,020]

@@mimib, I don't understand.... insurance approved, but you have to wait another 4 months? What prerequisites? My understanding is that either the beginning weight is noted, and/or the weight status is frozen as of the date of the approval.

I suggest you call either your bariatric coordinator or the insurance company, to make sure any weight differences after the approval even matter at all.

[MJB55 30]

Let your doctor know about your insurance.... im sure they will fit you in.

my doctor got me in for Dec. 31 because i told him i had a high deductible (3600.)

and had met it for the first time this year.They don't want to go through all this work

to lose a surgery.

[blondiebabs 214]

If they can't find time to fit you in, call your insurance company and ask if your authorization can be amended to a different surgeon/surgery group, if it can't then the new one you choose will have to submit for a new auth, but they should still be able to use all the same letters etc as before.

[MrsB2007 90]

Yeah.. I called and they said everything would have to be resubmitted. By the time that gets done it will be the same approx surgery date.

[blondiebabs 214]

Have you called any other nearby facilities and asked how quickly they'd get you in? Maybe someone would get you in right away to get you set up as a new patient, then submit your paperwork and hopefully have you in for surgery by the end of next month instead of March or April. If their auths only takes 2 weeks for approvals it's possible. =)

[CountryGirl5584 115]

I would explain your situation to the surgeon. Most offices will try to squeeze you in.