Question:
IS IT NORMAL TO GET A DATE FROM DR. BEFORE INSURANCE APPROVAL??
— SUSAN L. (posted on July 22, 2002)
July 21, 2002
It is my doctor's normal protocol to do an initial consult, send you for
psych and nutrition eval, have 2nd consult, set surgery date, then go for
your insurance approval while you have the rest of pre op testing. If you
are denied, he maintains your pre op testing as valid through the appeal if
it takes less than ninety days. He feels that it is best to get all the
pre op testing etc done prior to insurance approval, that way you are ready
to go with a surgery date. Most insurance requires a surgery date for
their records anyway, though I know many doctors give "dummy
dates" and then arrange their schedule around insurance approval.
Good luck!!
~CAE~
— Mustang
July 21, 2002
My doctor generally does not set a date until you are approved, because his
scheduled is booked up over three months in advance, however, in my case he
did after a failed appeal with Cigna HMO. I told the office that I was
changing to United Healthcare PPO (which they said approves 99% of their
cases) and that if I wasn't covered, I would take out a loan to self-pay.
They did want to get me a surgery date as soon as possible anyway, because
I have been having severe gall bladder attacks and have irregular liver
functions as a result. I think it all depends on your doctor and your
case.
— Laurie V.
July 21, 2002
I don't think it is a good idea to date your doctor... = ) Sorry I am in
a silly mood. It depends on the Dr. Some date before approval others wait
until after. Just make sure you have the approval before you have the
surgery!
— Virginia N.
July 22, 2002
My surgery was scheduled before my approval. The nurse scheduled me, then
sent everything to insurance for approval. I think it's a time saving
thing because surgery was scheduled 2 months from consultation and she
expected to recieve approval during that wait time. And, indeed, I have.
Only 2 more weeks.....
Good luck!
— Jen A.
July 22, 2002
Virginia that was funny! LOL :) All 5 surgeons from the Obesity clinic in
my area do that, so its normal to me. And if you do not hear from insurance
the day before, they will just push your date back until you get it (they
pretty much assume you are not paying out of pocket, not many people have
over $20,000 on hand!) I heard from insurance 2 weeks before my surgery and
was exstatic! :)
— Lezlie Y.
July 22, 2002
Most of the doctors around here won't even see you til you have been
approved. And you have to go through the battery of testing before your
first appointment too, if I'm reading the posts right. I went out of town
for my surgery and not only did I get my date before the insurance
approved, I got it before I actually had my first consultation. But, I had
special circumstances: my insurance was changing in 6 weeks and I didn't
know if the new company would cover the surgery so the docs office worked
with me to get me in to see him and have the surgery before the policy
change. We made it too - my surgery was on November 29 and my insurance
changed while I was hospitalized on December 1. So, I would say, it
definitely depends on the doctor. I happened to have found a surgeon who
was very interested in helping me. He even gave up a planned day off so I
could have my surgery.
— Patty_Butler
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