I am switching surgeons AFFTER insurance approval. HELP......

I have seen a roux-n-y surgeon and received "Approval for medical necessity" from our insurance based on this surgeon. I found out that both the surgeon and hospital is out of our PPO network after I was approved. Now I want to "switch" to a surgeon and hospital that is part of our PPO network. The insurance company tells me that I will have to go through the approval process all over again because I am changing surgeons. The office staff at the "new" PPO network surgeon's office claims that the insurance representative is INCORRECT and that I DO NOT have to be REAPPROVED. They claim this happens all the time and I should let their insurance specialist deal with my insurance provider. I don't know who to believe at this point. But, I'm sure in the end I will be the one left holding the "bag" since I cannot get an accurate answer. Has anyone been in this situation. If so please help as I don't want to be denied benifits because I was "Approved with surgeon A" and "Not Approved with surgeon B", but "Approved for the procedure". Sticky situation I got myself into. Help..... Sincerely, Bill in Ohio

We greatly appreciate your interest in helping us build our Q&A database. To discourage vandals from posting garbage, however, we require people to register before posting.

You must be logged in to post an answer. Click here to log in.