Question:
I have a question about insurance plan administrators......

What I am wondering is who makes the decision as to surgery approval? I am insured with Insurance Management Services but my insurance card says it is actually through Beech Street/Capp Care. Now, the lady I spoke to in the doctor's office said that IMS is really a bear to work with and might be denied. I tried to tell her I had already called the benefits person with this company and had been told they did in fact approve surgeries for two people: a RNY and a VBG. She had cut me off before I had a chance to tell her that. Anyway, that aside, If IMS is the administrator, does Beech Street/Capp Care actually approve the surgery? Any help at all would be appreciated.    — Diana M. (posted on March 21, 2001)

March 24, 2001
Diana, The administrator has a lot of pull on making decisions, but the ultimate choice would be with Beech Street. If you think you are getting a run around with IMS, call Beech Street directly and try going through them. You are paying for this service, use it to your advantage. If you can't get help with one person, hang up and call back and talk to someone else. Persistance is the key. Good luck.
   — Dawn R.