Insurance concerns
I would call the insurance company first thing in the morning and ask them what happens. Also, does your surgeon have priveleges at any other hospital?
Another reason I would talk to the insurance company is to verify that the hospital is out of network in the first place. The billing dept in most hospitals is pretty disorganized, and errors happen all the time, many that seem like no-brainers to the rest of us, usually over a typo or something along those lines.
Another reason I would talk to the insurance company is to verify that the hospital is out of network in the first place. The billing dept in most hospitals is pretty disorganized, and errors happen all the time, many that seem like no-brainers to the rest of us, usually over a typo or something along those lines.
Highest weight: 277 Starting Weight: 250 Surgery Weight: 241 Current Weight: 130
Goal Reached in 10.5 months :)
Luvnall3
on 7/25/12 12:43 pm
on 7/25/12 12:43 pm
Hi racemom,
I am pre-op and waiting for approval from my insurance.(UHC) But what happened with me, is that there were not any in network surgeons that perform bariatric surgery in my town. Hospitals, but no surgeon. So I called the insurance and had them do a look up for the nearest surgeon and to see if I could go to the nearest hospital to him or if he could travel to one of our hospitals to perform the surgery.Nearest one was over 100 miles. They came up with a program that helps patients not have to travel when undergoing major surgery.(they want to keep you as comfortable and close to home as possible) So I had an exception called the GAP exception. Which is filing for an out of network provider to be approved as a temp. in network, to avoid travels. It worked and in 5 days the surgeon in my town was approved as in network. It may be different for each insurance. But worth asking about. I hope that helps and good luck to you. Keep at it, don't give up.
I am pre-op and waiting for approval from my insurance.(UHC) But what happened with me, is that there were not any in network surgeons that perform bariatric surgery in my town. Hospitals, but no surgeon. So I called the insurance and had them do a look up for the nearest surgeon and to see if I could go to the nearest hospital to him or if he could travel to one of our hospitals to perform the surgery.Nearest one was over 100 miles. They came up with a program that helps patients not have to travel when undergoing major surgery.(they want to keep you as comfortable and close to home as possible) So I had an exception called the GAP exception. Which is filing for an out of network provider to be approved as a temp. in network, to avoid travels. It worked and in 5 days the surgeon in my town was approved as in network. It may be different for each insurance. But worth asking about. I hope that helps and good luck to you. Keep at it, don't give up.
31 yrs. old~Height : 5'4" HW: 265 * SW: 263 * CW: 181 * GW: 160
Also - -sometimes the doc or hospital's contract expires in the middle of your insurance benefit year. When that happens you are often SOL. Definitely tell them that you are in the middle of a treatment plan, and ask them what options the insurance company is offering patients who need to transition to in-network providers.
They may have another option that will enable you to stay on schedule -- and ask why you can't continue with this doc/hospital until your surgery is over since this change was outside of your control (as long as it happened within your plan benefit year, they should make every effort to make sure you aren't affected).
They may have another option that will enable you to stay on schedule -- and ask why you can't continue with this doc/hospital until your surgery is over since this change was outside of your control (as long as it happened within your plan benefit year, they should make every effort to make sure you aren't affected).
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