crazysexycool93 5 Posted September 23, 2015 I need you guys help! I have met all of my deductible and majority of out of pocket for surgery but the kicker is that if I don't have surgery by January 1st I lose all of that. Can someone give me some advice on what I can do to speed up this process? Share this post Link to post Share on other sites
Tssiemer1 549 Posted September 23, 2015 Self pay? Do you have a 6 month diet requirement? Share this post Link to post Share on other sites
BLERDgirl 6,417 Posted September 23, 2015 Talk to your bariatric program and make them aware of this. Share this post Link to post Share on other sites
crazysexycool93 5 Posted September 23, 2015 Self pay? Do you have a 6 month diet requirement? I do have a 6 month requirement but October 15th will be month 4. I'm with United Health Care. Talk to your bariatric program and make them aware of this. I just called them they weren't too helpful!! ???? Share this post Link to post Share on other sites
Tssiemer1 549 Posted September 23, 2015 That puts you in November. Have you done everything else? Share this post Link to post Share on other sites
crazysexycool93 5 Posted September 23, 2015 My psych evaluation is next Wednesday and that's it. Share this post Link to post Share on other sites
ShrinkingPeach 1,291 Posted September 23, 2015 Once all the info is turned in to insurance it typically goes pretty fast. Make sure and double check that everything is done and make sure your surgeon's office gets it all turned in ASAP and then become the squeaky wheel to the pre-cert department of your insurance company. Good luck! Share this post Link to post Share on other sites
cindyw41 761 Posted September 23, 2015 (edited) The end of your 6 months will be Dec right? That puts your possible surgery right around the holidays. If your surgeons office is on the ball it can be done. Providing your insurance gives you a super fast approval. Realistically surgery will be in January. Sorry. Edited September 23, 2015 by cindyw41 Share this post Link to post Share on other sites
LoseItKacy 347 Posted September 23, 2015 I had the same problem my clinic worked around it. My start over date is October first. They got me in for September 30th! It was a close call but I'm very lucky! I would keep bringing it up to them. Share this post Link to post Share on other sites
TheMix 8 Posted September 23, 2015 I am in the same boat.. A rep from the surgerons office called me today becuses I emailed them last week to see if this could be done.. I have to complete 4 NUT appts which will put my last appt on 12/17 she said moset likly it is far fetched to have everything done and approval and surgery date by the end of the year she said possibly you can call the ins co and see if the paperwork can be submiuted early SSOOOO I called the ins co,, and asked that if I had everything else done,,, by the 11/17 appt,, and all i had left was the last nut appt on 12/17,, could the paperwork be submitted,, ,she said yes... ssoooooo I called Ava back,, she said it is still unlikly that it will get approved in time.,. i said,, so your saying that it cant be done,, she said no,,, its just highly unlikely... if you get declined,, then we have to do a peer to peer meeting to try to get it over turned,,, and its a lot of time and paperwork I have a PT appt tomorrow,,, and a sleep study on sunday and bloodwork and chest xray next week... doing everything I can but she sounded so negitive... should I still try?? Share this post Link to post Share on other sites
crazysexycool93 5 Posted September 23, 2015 I am in the same boat.. A rep from the surgerons office called me today becuses I emailed them last week to see if this could be done.. I have to complete 4 NUT appts which will put my last appt on 12/17 she said moset likly it is far fetched to have everything done and approval and surgery date by the end of the year she said possibly you can call the ins co and see if the paperwork can be submiuted early SSOOOO I called the ins co,, and asked that if I had everything else done,,, by the 11/17 appt,, and all i had left was the last nut appt on 12/17,, could the paperwork be submitted,, ,she said yes... ssoooooo I called Ava back,, she said it is still unlikly that it will get approved in time.,. i said,, so your saying that it cant be done,, she said no,,, its just highly unlikely... if you get declined,, then we have to do a peer to peer meeting to try to get it over turned,,, and its a lot of time and paperwork I have a PT appt tomorrow,,, and a sleep study on sunday and bloodwork and chest xray next week... doing everything I can but she sounded so negitive... should I still try?? . Yes I'm not giving up until January first!!! Good luck ❤️ Share this post Link to post Share on other sites
crazysexycool93 5 Posted September 23, 2015 I am in the same boat.. A rep from the surgerons office called me today becuses I emailed them last week to see if this could be done.. I have to complete 4 NUT appts which will put my last appt on 12/17 she said moset likly it is far fetched to have everything done and approval and surgery date by the end of the year she said possibly you can call the ins co and see if the paperwork can be submiuted early SSOOOO I called the ins co,, and asked that if I had everything else done,,, by the 11/17 appt,, and all i had left was the last nut appt on 12/17,, could the paperwork be submitted,, ,she said yes... ssoooooo I called Ava back,, she said it is still unlikly that it will get approved in time.,. i said,, so your saying that it cant be done,, she said no,,, its just highly unlikely... if you get declined,, then we have to do a peer to peer meeting to try to get it over turned,,, and its a lot of time and paperwork I have a PT appt tomorrow,,, and a sleep study on sunday and bloodwork and chest xray next week... doing everything I can but she sounded so negitive... should I still try?? they said I would have to do a pre-determination request. Have u heard of that?? Share this post Link to post Share on other sites
_Brooke_ 45 Posted September 23, 2015 (edited) Yes.. my insurance required it. They denied my pre determination the first time and then approved it the second time.. I was approved on 9/15 and I have my surgery tomorrow (9/24).. It's pretty normal to have to get a pre determination if you have bcbs Edited September 23, 2015 by _Brooke_ Share this post Link to post Share on other sites
crazysexycool93 5 Posted September 23, 2015 Yes.. my insurance required it. They denied my pre determination the first time and then approved it the second time.. I was approved on 9/15 and I have my surgery tomorrow (9/24).. It's pretty normal to have to get a pre determination if you have bcbs I just messaged you. Share this post Link to post Share on other sites
ASUgrad 61 Posted September 24, 2015 (edited) . Edited October 18, 2015 by ASUgrad Share this post Link to post Share on other sites