Question:
Is it okay to apply for my pre-approval for surgery before having 1st Surgeon consult
I have the full support of my PCP and the law in MD has now changed so that insurers must provide coverage for the surgical treatment of morbid obesity. Is it okay for me to apply for my pre-approval before seeing my surgeon in August (and what part of the AWDA should I include in my packet when I do?)? — Alice J. (posted on June 15, 2001)
June 15, 2001
I did! I talked with pre-cert nurses at my insurance and already had all
information needed. Before you call, find out the procedure code of the
surgery you are expecting to have, a date in mind for the surgery, what
hospital, and of course your surgeons name and address. A nurse will ask a
few questions about previous weight loss attempts and ask if there are any
co-morbids. While you have the pre-cert nurse on the phone, ask them what
(if any) clauses could automatically decline your approval. Sometimes you
can run into a terrific nurse and they will help you out tremendously.
Good Luck!
— Jeanne M.
June 16, 2001
I called for my consultation appointment in September and was given a date
of Nov. 2. I then asked if I could go ahead and seek insurance approval.
The surgeon's office said yes and they sent me what information that they
required before they would submit. I spent about a month gathering all of
the info and writing a compelling diet history, getting my PCP referral,
etc. I sent all of that information to them mid-October and had written
insurance approval by Oct. 26th. I then went to my consultation with
approval and was able to get my surgery date on that day. I say don't
wait!! Go for it! It will definitely speed up the process.
— Shelley.
June 16, 2001
I would think it would depend on your insurance company. My insurance
company requires I see the surgeon before things can be applied for even
though when all is said and done when I get my approval I will be able to
go to whatever surgeon I chose. (In the even I change my mind - which I
won't because my surgeon is just awsome) Your best bet will be to ask
your insurance directly.
— Elizabeth D.
June 16, 2001
Thank you for posting this question, I was wondering the same thing.. how
encouraging! Thanks to everyone who has answered and good luck Alice!
— Joscelin
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