Question:
Has anyone ever got their surgery date before request for approval sent to Insurance?

I got my surgery date. I have my surgery Nov 15, 1999. I am having a lap RNY. My surgeon is Dr. Wetter in San Mateo, CA. I am excited about having the surgery but when I called to ask about where my Insurance approval stood, I was told that it hadn't been submitted as of yet. When I voiced my concern, I was told that they were trying to get the Insurance approval for those having surgery in October. My Insurance is PPO Blue Cross Blue Shield FEHP. Does this mean that my surgery will most likely be delayed pending approval or is this a sufficient amount of time? I am so eager for everything to go smoothly. I guess I am asking alot huh. I am sure I will have anxiety and many more questions regarding the surgery later, however now I am focused on Insurance Approval. I believe most of the emails I have read have been about getting approval so they could get a surgery date. Any one with this experience?    — mary S. (posted on October 5, 1999)

October 5, 1999
Hi Mary: I got my surgery date on my initial appointment with my surgeon. They they submitted for insurance approval. I received the approval in plenty of time for the surgery. My surgery date was 2 1/2 months after my consultation with the surgeon. I would guess since Dr. Wetter has done so many of these surgeries they have a pretty good system down on getting approvals. I also had a Lap RNY on 9/22. I am doing great so far. I see the doc. tomorrow for the "official" weight loss. Good Luck to you!
   — Dot W.

October 5, 1999
I jumped through ALL the hoops (i.e. consultations, psych eval, nutritional eval, etc.) and was scheduled by my surgeon for a date BEFORE my request was sent to my insurance company. I was approved a week later. I'm not sure why it worked out that way, but it did. Good luck to you!!!
   — Brealynn

October 5, 1999
That depends entirely on your insurance company and your coverage. Assuming there are no exclusions for this procedure, you've got plenty of time, however, if there are any gray areas, I'd tell your surgeons office to get the paperwork moving NOW!!! October is here ... November is only a couple weeks away!
   — Sherrie G.

October 5, 1999
Yes, my surgery date was set up in August and my insurance was not submitted until Sept. 24th. By the way I BC/BS of WY and I had approval on SEPTEMBER 30th. I had the same fears that you have but don't let all the little voices in your head drive you crazy. I know all of my little voices came real close to driving my insane. Hang in there these Dr.s and their staff seem to know what they are doing. Take Care. Chris
   — Christine H.

October 6, 1999
I made my surgery appointment and pre-op appointment at the initial consultation, pending approval. I made the appointment for about 2 months away, to give them time for the insurance approval to come in. And it did come in, it only took 4 days. I could have scheduled it for the NEXT week, little did I know!
   — Bridget M.

October 6, 1999
Hi Mary: I got my surgery date scheduled before I got my approval, but my surgery date is so far away (Dec. 8) that my surgeon says that he will have the approval by then. Hopefully...... He just doesn't to make me wait months after I get the approval to schedule me since he only does this once a week, and those dates fill up fast. I scheduled my date in September and the first available date that he had was December 8. So I would have to wait about 2 months to get a date after I got the approval....He's trying to save time for me and I appreciate it. But I try to keep positive thoughts. Good Luck!!!
   — Dannielle K.

October 6, 1999
Hi Mary, My surgery is scheduled for Oct. 9. I got the date the first time I visited my surgeon, Dr. Kirkpatrick, Washington Hospital Center, D.C. The office then submitted my paper work and about 5 weeks later, on July 13th (can't remember the date of my first apt.) Peggy from the doctor's staff called to say my surgery had been approved. I have Blue Cross/Blue Shield Federal PPO. Good luck with your approval and surgery.
   — kaydeeb16

October 6, 1999
My initial consult with my surgeon was in June and they actually wanted to schedule my surgery for the following month; however, I had some conflicts so we schedule in August. This was all done way before the authorization request was submitted to my insurance company (Aetna PPO). I found out that the request wasn't faxed over until the first week of July. The authorization came in about 4 days before my surgery date. Yep, it right down to the wire like that. I was relieved. I was told on a Tuesday that I had been authorized for this surgery and on that Thursday I went to the hospital for my pre-op work up. The next day, Friday, I received a call from the surgeon's office telling me that they had to cancel my surgery for Saturday because the doctor was ill. I was so bummed. The following Monday I called to reschedule and they gave me a date in September. I didn't like that too much because my home support wouldn't be available. About 15 minutes after the first call, I received another call from the surgeon's office telling me there was a cancellation for the next day, Tuesday, and would I care to take that appointment. Needless to say, I jumped at it. So, in short, yes I had my date before I ever had authorization and I experienced just as much anxiety as those who are waiting for authorization so they can pick a date. I never even dealt with the insurance company. Dr.'s office did it all and I got approved in about 8 weeks. Every insurance company has different Utilization policies and all I can tell you is to remain in contact with your surgeon's office so they keep you a priority.
   — Talullah

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