Help! I can't even get insurance to give a denial w/ specific reason

I have Sloans Lake insurance. There is an exclusion for all WLS. Immediately following the exclusion it says "all medically necessary treatments for morbid obesity will be covered". I went to a surgeon a couple mos. ago. Initially they were told by insurance that WLS is covered but requirements will follow. They then got ins. approval for the Pysch evaluation, which I have completed. Then I received a copy of an insurance letter sent to the surgeon now stating that "based soley on the information provided that it appears this procedure (lap band) is not covered by the provisions of my insurance plan". It goes on to state that my plan does not require pre authorization and that final determination of benefits will be determined once the procedure has been completed and a claim is filed". OK, so I'm supposed to have the surgery and take my chances on if they'll pay???? I've called the insurance company 2x's and they simply continue to read the explanation of benefits page. I ask them what constitiutes medical necessity for WLS and they tell me they have no idea that I need to get the insurance mediator on the phone - who is never available. How can I get insurance to even respond? I gave the surgeon all my medical records including 6 mos. DR. supervised weight loss effort (just in case that's a prelim requirement), and other records stating co-morbidities. How do I find out the requirements for medical necessity from my insurance company and unlike EVERYONE else why is my insurance company not sending me a denial but simply stating that pre-authorization is not required when I've had to get pre-authorzation for everything else I've ever had done w/ them. Anyone have this issue? Thanks, Kim

Get your H/R dept involved. They should be able to get a clear answer from them.