Who submits the initial paperwork to insurance?

[Who'sThere 331]

I thought that my PCP would submit the initial paperwork, but from what I'm reading, so people meet with the surgeon first. Who submits the initial paperwork to the insurance company, one's PCP or surgeon? If the surgeon submits it, does insurance pay for the consult with the surgeon? I have UHC.

Thanks in advance

[moonandstarzz 0]

i had to pay for my surgeon consult but they said if i had the surgery and was approved by ins that i would be reimbursed the consult fee. my pcp faxes all the info over to surgeon for my 6 mth diet and my surgeon faxes everything to the ins. hope that helps

[Nancy33 0]

I called the doctor first to get things going.

My doctor had me call first to make sure that I was covered. Of course getting a "Yes, you are covered "is never going to happen, to many things to take into consideration, but once you find out that your company has in the past covered the band, I would let the doctor submit what they need. They know how to get the job done in most cases. I have heard about doctors who leave all of the insurance stuff up to you and I don't think those claims are as successful. Don't give up!

[Jodi_620 37]

I went to the seminar first then went to my consult which was $370 out of pocket. I didn't even discuss surgery with my PCP prior to going forward (although I did mention it to my Endocrinologist who was all for it). While I was in consult with the surgeon the coordinator was calling the insurance company and getting specifics on coverage, she handled the whole approval process. The only involvement my PCP had was doing bloodwork, EKG and submitting a Surgical Release Letter to the surgeon all of this was done after I had already been approved through insurance.

If I remember correctly the $370 consult fee covered the insurance approval process among other things.

Edited July 2, 2008 by Jodi_620