megieg 7 Posted September 24, 2015 I am still waiting on my denial to be over turned, If I go ahead and pay out of pocket for my surgery, if my insurance pays for it will they reimburse me? Share this post Link to post Share on other sites
Bufflehead 6,358 Posted September 24, 2015 Doubtful, but you would need to talk to an attorney to be sure. Share this post Link to post Share on other sites
Tssiemer1 549 Posted September 24, 2015 I doubt it. Share this post Link to post Share on other sites
BLERDgirl 6,417 Posted September 24, 2015 I am still waiting on my denial to be over turned, If I go ahead and pay out of pocket for my surgery, if my insurance pays for it will they reimburse me? Probably not. Unless you have it in writing insurance will not reimburse. Share this post Link to post Share on other sites
Sharon1964 2,530 Posted September 27, 2015 They won't, because the authorization date will be after your surgery. So if you have surgery on 10/1, and on 10/15 you are approved, your authorization will be something like 10/15/2015 to 12/31/2015. Share this post Link to post Share on other sites
The Candidate 3,215 Posted September 27, 2015 I wouldn't do anything until you have that authorization in hand. Share this post Link to post Share on other sites
Jersrose43 837 Posted September 27, 2015 And even if they do reimburse you. It would only be their normal reasonable payment. Which tends to be 30% of what a doctor and hospital actually charge. Wait. My charges were $42k for hospital. Insurance paid $4800 The surgeon was $20k and insurance paid $4200. Anesthesia was $3800 and they paid 100% Share this post Link to post Share on other sites
Trinn 139 Posted October 12, 2015 Nope. And it's really important you don't do this. Once you've had the surgery, no one has any incentive to get the insurance to approve; the hospital, etc, will just be trying to get it from you. You have to have that approval *before* you have the surgery. Share this post Link to post Share on other sites
newmebithebypass 713 Posted October 24, 2015 most insurances will only pay for one weight loss surgery per life time so even if you have it with out it they might not cover it anyway Share this post Link to post Share on other sites