Insurance Question Ohio

tamaraw
on 3/1/16 8:36 am - Lima, OH

Hi all!

    I received the CPT code from the surgeon. My insurance company Medical Mutual of Ohio said it came up " Prior Authorization Required" is that a bad sign or good? The policy does not exclude gastric bypass but the agent said it doesn't allow it either.. Huh? 

  Any thoughts? Please, I could use some guidance. 

 

hollykim
on 3/1/16 1:36 pm - Nashville, TN
Revision on 03/18/15
On March 1, 2016 at 4:36 PM Pacific Time, tamaraw wrote:

Hi all!

    I received the CPT code from the surgeon. My insurance company Medical Mutual of Ohio said it came up " Prior Authorization Required" is that a bad sign or good? The policy does not exclude gastric bypass but the agent said it doesn't allow it either.. Huh? 

  Any thoughts? Please, I could use some guidance. 

 

"prior authorization" means the procedure has to be appeoved by your insurance before it is done,or they will not pay for it. 

Pas to whether or not it is a covered benefit,I would ask tobe sent a copy of he policy where it says it is not excluded and not covered then you can I read it for yourself.

 


          

 

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