Switching Surgeons

midiva
on 10/6/14 8:01 am - MD

I had lap band surgery in 2007 and it has not been successful.  I am seeking a revision and went to Dr.Afram in DC.  However, he only  does open roux en y and I caught his staff in a lie twice.  They said they had submitted the info to insurance when they had not.  I have scheduled an appointment with Dr. Kuldeep Singh for this week.  My question is if one office gets the approval can I transfer that approval to the other surgeon?  

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WLStruggles
on 10/7/14 3:08 am

My situation is not like yours but I was able to transfer all the work I had completed at one surgery center to another when things were going south with the first group.  We had not gotten as far as insurance approval.   They reverified my benefits.  I completed the requirements of the new center that were in addition to what I had done at the previous one. The records of everything I had done were transferred over and I did not have to repeat (labs, physical, etc)  I had to redo the Psych exam, although I think they told me I could have requested that be sent over as well, I just had to do it separately.  I would think you would have to get a new approval since it's a new Dr, but I don't know why the answer would be any different.  If you were approved once, why would you be denied the second time around?  It will likely just take another week or two…...   

        

mschwab
on 10/7/14 8:48 am
RNY on 11/21/14

You should check with your insurance company about switching surgeons and how it impacts your coverage approval.  Switching surgeons probably won't impact your approval for the surgery in general, but there are all kinds of administrative challenges that switching surgeons may cause (e.g., the approval specifically lists a particular surgeon and the claim will deny if it is not submitted by that surgeon, you might be limited to specific surgeons participating in your plan, etc.).  This can vary policy by policy at the same insurance company, so don't assume that someone else's experience will be yours.  The only way to know for sure is to call your insurer.

 Height: 5'7".  HW: 299, Program starting weight: 290, SW: 238, CW 138 - 12 pounds under goal!  

     

midiva
on 10/7/14 11:19 am - MD

I plan to call Aetna Thursday after my appointment.

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Bibo
on 10/11/14 8:02 am

I had been approved, and went to my pre-op and wound up firing my surgeon....the insurance approval at the new place was not bad..I still had to go to their class, but they used all my other psych testing and reports, took about a month and insurance approved no problem. I am so glad i switched...wound up waiting a little while longer for surgery but I am MUCH happier with the new clinic and the new surgeon. He has done two more operations on me, and the program support staff have been wonderful. Worth the wait!

    

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