Pre-op steps Question?

(deactivated member)
on 5/13/14 12:44 pm

I received a surgery date of June 17 for my sleeve. My insurance does cover this type of surgery. I have done all my insurance required steps. I have had an upper GI two weeks ago. My question is this I need to do a chest X-Ray, EKG, blood work, and see my primary for history and physical and get a pregnancy test, will this hold up my insurance approval? I have an appointment with my primary the first week of June.  But all these steps need to be done 3 to 14 days prior to surgery. Does insurance approval move that fast or are these things only for the surgeon? 

kathkeb
on 5/13/14 1:01 pm

Generally, the insurance is going to pay for the surgery and will bill separately for the pre op tests.

 

In my case, my insurance did not pay for my surgery, but it did pay for my cardiac appointment, and my blood work and other pre op tests.

 

I think that your visit to your primary will just be billed to insurance as routine medical, and subject to co-pays and deductibles.

Kath

  
kathkeb
on 5/13/14 1:01 pm

Generally, the insurance is going to pay for the surgery and will bill separately for the pre op tests.

 

In my case, my insurance did not pay for my surgery, but it did pay for my cardiac appointment, and my blood work and other pre op tests.

 

I think that your visit to your primary will just be billed to insurance as routine medical, and subject to co-pays and deductibles.

Kath

  
diane48
on 5/13/14 1:22 pm
RNY on 05/07/13

You could call your insurance and ask them.  There is usually a customer service # on your card that you can call for any questions. 

    

 

 

 

 

 

 

    

SuzinDallas
on 5/13/14 10:44 pm

Most Dr's won't schedule surgery until they have approval from the insurance company. Since the remaining tests you need need to be done within a specific time frame before the surgery I'm wondering if they are tests that your Dr requires before surgery to ensure that you are medically fit?

I had to have blood work two days before my surgery, he sent me to do it after my Pre-Op Exam with him and I was also registered at the hospital at that time. While waiting I met another woman who I'd seen in the waiting room at my Dr's office.  We got to chatting and she was also there for her pre-op and she was having a chest X-Ray and EKG in addition to the blood work.  The testing required by the Dr typically differs by patient depending on medical history and what sort of surgery you're having. My Dr already had recent info from my primary as I was documenting issues with my lap-band since it was a revision. They did an EKG while I was waiting to go into surgery that morning.

Your Dr's office should be able to answer that question quickly though.  My Dr's insurance coordinator went over what my policy required and what my Dr required so I understood how the process worked, she did this at my consultation when I said I'd like to move forward with the process.

     

Revision from Lap-Band to RNY May 2014.  

Revision Consultation: 326   Day of Surgery: 310   Current: 250   Goal: 150

(deactivated member)
on 5/15/14 12:27 pm

I called my insurance company. Seems everything is ok. Like everyone stated, the list of procedures are for the insurance. Thanks for everyone's responses.

Katherine2014
on 5/15/14 12:16 am

Hope it all comes together for you. My date is also June 17th!! Good luck!!

(deactivated member)
on 5/15/14 12:27 pm

Cool surgery buddy. 

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