Will insurance reimburse me after I self-pay?

I was denied by my insurance a few months back because I did not have proof of being overweight for 5 years. The Dr's office referred my case to Walter Lindstrom, and they are currently working on my appeal. He said it could take up to six months to get a decision and I really don't want to wait that long just to be denied again, so I decided to selfpay and I am having my surgery the 28th of this month. If by some chance my insurance approves me, do you think they will reimburse me for the money that I self-paid?

I wouldn't count on it.  When I worked for BCBS of FL the date of the pre-authorization was very important.  If they approve you in June, they most likely would not be willing to pay claims from before that date.  I don't know that anyone can say for sure what your insurance will do, but it's definitely a risky situation.   WLS is expensive.  I know 6 months sounds like an eternity now.  Wouldn't it be nice to wait the insurance out for approval?  Then you'll have all of your cash left to pay for a wedding, college, new car, house, etc.  Patience is not a virtue that I have in most situations.  I don't want to give you that talk about how differently you'd feel about the money when you get a little older.  At 26, I definitely make better financial decisions than I did 5 and 6 years ago.  I would encourage you to really think about how much money you could potentially save.   Good luck! 

Forgive me if I sound harsh but... That is a VERY risky idea! Your biggest concern should be that if  you have ANY problems related to WLS and it has not been approved by your insurance you are looking at a HUGE bill !!  What if you end up in ICU, even for a day? You could be looking at a 100k bill that is all on YOU.   To shed more light on this, I have a patient not that has been in the hospital since LAST July for a RNY that developed a leak.  You do NOT want to have to self pay for that!   If it was going to be a flat out $20k that is one thing, but you are gambling here.  You are setting yourself up for financial ruin.  (With the new bankruptcy laws, I believe you would still have to pay your bills, you would just be on a payment plan.)  If your insurance does not approve this, they can deny ALL claims they think is remotely related to your WLS  (like if you need a future iron transfusion, ANYTHING...)  Ins companies can be nasty.   I would not take that gamble.  Esp since with a lawyer it is VERY likely you will get approved!  Cool your jets and let your lawyer do the work. I know you are impatient; I am too.  Also, he said it could take UP TO 6  months; it might only take 6 weeks! Melanie g.

I totally agree with this post. I wouldn't risk it if there is even a chance that it is covered for all the reason's above.

I work for an insurance company and i can tell you if you do the surgery without authorization there would be NO way they will pay for anything, they will deny all the claims stating preauth not obtained.

Thanks, I figured it would be a long shot. Oh well.