Insurance wait

[zanzibar24 0]

Hi all. I have a January date and staring my preop diet today. I’m not sure if the insurance approved yet, or if they will. How long did your insurance take?anybody have to postpone because of insurance?

[NickelChip 1,299]

Does your insurance have specific guidelines for qualifying? For example, mine required a BMI over 40 or over 35 plus a certain number of comorbidities from a specific list that they provided ( I can't remember the specifics now, but I do know they were spelled out clearly in writing). They required 6 months of regular appointments, including weigh-ins, with the team of dietician/surgeon/behavioral health specialists. They required a panel of blood tests, as well as a letter from the primary care physician in support of the surgery. Once those requirements were fulfilled, approval was a formality. We knew before the request was submitted that it would be approved. The actual approval took maybe 2 weeks to process and I was able to find the information by logging into my insurance portal and looking under the section for authorizations. Your surgeon's office should have someone on staff who is an expert at dealing with insurance who can tell you exactly how the process is expected to go. My office submitted my paperwork a standard number of weeks before the surgery, something like 3 or 4 weeks, I think.

[guinea pig 3]

Same here with insurance requirements. Until insurance approval received, my office would not schedule surgery. Sounds like you are approved.

[zanzibar24 0]

There are guidelines, and i met them. Consecutive surgeon apts and nutrition apts, tests, and medical need. I am having a band removed, a hernia fixed, and the sleeve procedure. I checked the insurance site but did not find information. I emailed the dr office, but with the holidays, may not there until the new year. I am a nervous/anxious person, so I am worried this plan and date are going all too well and some wrench is going to be thrown into the mix. It would be just my luck that I am on this preop diet and things may get delayed.

[ShoppGirl 4,973]

I get your anxiety as I struggle with it as well and I’m pretty sure that I worried about the same thing but I would be surprised if they would have scheduled your surgery or your preop appointment if the surgery hadn’t been authorized. These surgeons are beyond busy and their office and surgical time is limited and worth a lot of money.

Think about it, If they schedule you before they should and end up with a slot they can’t fill the Surgeon loses money and I’m sure they aren’t very happy if that happens too often. With the preop and authorizations required for this surgery it’s probably pretty difficult to fill an opening. They would need someone else that’s just been approved by insurance and still has over two weeks notice to do their preop appointment with the surgeon and start their preop diet and that date works for them and their driver. Most likely those people would’ve already been scheduled with their own date or they won’t be able to do surgery that date for one reason or the other.

Long story short, they probably already got your approval and just didn’t tell you. That or they deal with your insurance company alot and they know the exact criteria and turnaround without a doubt. You really should be fine.

Edited January 4 by ShoppGirl