Insurance Approved Today BUT??????

Lopez1978 · November 5, 2008

I have been working with a Doctor locally which was an out of network doctor trying to get banded for almost a year. I had to do the 6 month diet thing, completed that. Then my doctor sent paperwork in to insurance and while I was waiting for approval, I was calling trying to find out how much $$ I would have to come up with before surgery. They told me today I was APPROVED and would have to come up with $3000 for surgery with the out of network doctor:eek:. The closest in network doctor I found is three hours away.. I called my insurance and asked what I would have to pay if I used an in network doctor, and they said after I meet my deductible it would be covered 100%. So I have met my deductible already so I am guessing I don't have to pay anything out of pocket. I have an appointment tomorrow with the in network doctor, but they will have to resend in all the paperwork and get approval themselves..I am wondering if this process will be quick because it was already approved by another doctor, or what? Has anyone else experienced this? Just wondering what to expect. And also wondering if it would be worth it to drive the 3 hours and pay nothing or stay locally and struggle to come up with $3000, which I do not have? Would appreciate your insight. Thanks and can't wait until surgery.... :lol:

RHS · November 5, 2008

My dr. is out of network for me too but I spoke with him about that and he said that he was willing to take what the insurance company gives him and not want any money from me so ask him it can not hurt..it might just save you a 3 hour drive every 6 weeks.lol

zoomomma · November 5, 2008

I understand. I have to drive three hours for the closest one in network or not. I would take the drive, in the end it will cost less and you wouldn't have to worry about coming up with the money. After all, if you can't afford the surgery you would have to wait until you could and then that would really suck. And what if you never came up with the money? Three hours is not really that long a drive. I do it almost every month between my two boys' psych and me with my doctors. Anyway, just my thoughts. Hope it helps.