Submit to Insurance 1st day of Coverage?

brownbeauty · February 27, 2008

I went through the Pre-op process with the surgeon that I would like to do my lap band surgery about 4 months ago. Back when I had United Health, the surgeon's practice was not IN Network so they did not submit to insurance. I have since changed coverage (my husband got a new job). March 1 we will have Blue Cross Blue Shield, who is contracted with my surgeon's practice. The insurance department has seen 100s of surgeries approved with Blue Cross Blue Shield. I am so very anxious to have the surgery done, I would like to submit the claim for the Lap Band March 1, the day coverage starts./ Do you think that is a good idea?

I am pretty sure I will be approved, my BMI is 44. The policy states that obesity surgery isn't covered unless it is deemed to be "medically necessary" - which mine is, I am 28 with HBP and Morbidly OBESE.

Please advise as to what I should do. Do I wait it out or submit right away?:smile2:

Thanks!

Brown Beauty ♥

mynmann · February 28, 2008

I am sort of going through the same thing. Except I haven't seen a primary doctor yet. My insurance starts Friday as well and I've been wondering what to do. I'm a bit nervous they'll claim it as a "preexisting condition" if I file to quick. Which is silly, cause it would have to be. They want you to have been overweight for 5 years or more... so I'd of had to have been with the same insurance company since I was a teen for it not to be pre-existing.

Anyways, I'm not sure but if I find out I will contact you.

Myn