No Date: Prior Auth

Hello everyone, so yesterday so joined and shared a little about me. Today I had my consultation visit and made a plan for a TLH possible RSO. I did research about my different choices before I went so I was prepared. So my Dr. says that they will start my prior auth and someone will call me. We have not set a date until the approval is done. I was wondering how long will that part take to get the approval. I am on <>. I don't know if they cover this procedure or not, but I hope so. I am so tired of being in pain almost everyday. Can anyone advise if they are aware if the state will cover it?

I don't know for sure but I would think as long as the doctor recommended it they would. Is there a number on your insurance card? Maybe you can call them and ask if this would be a covered procedure.

[quote=stephstro;4202627]I don't know for sure but I would think as long as the doctor recommended it they would. Is there a number on your insurance card? Maybe you can call them and ask if this would be a covered procedure.[/QUOTE


Thank you so much, I didn't even think about that. That's a great idea.

Hi there. I am in the health care insurance industry where we provide the authorizations. There should be very little reason that your auth is denied, as long as the physicians and facility where the services are going to be done are within your insurance's network. I also had to have my procedure authed and it went through no problem. It also shouldn't take very long. As others have posted, you should call your insurance if you're concerned. Also, maybe you should schedule the procedure now so that when your auth is approved, your appt is already set to go and you don't have to wait for that.
Good luck!

The time it can take to get a preauth depends on the state laws (in the US) and the type of insurance plan you have. Some states say health insurance companies have to make a decision within 72 hours, others say 30 days. Again, you should be able to call your insurance company and they'll tell you what the turn around time is.

Good luck!

Some insurance companies may want you to try more conservative treatments before they will pay for a hysterectomy. Depending on what your issues are there may be less invasive options that could be tried first, and insurance companies may push for the cheaper option first.

Other insurance companies approve with no problem on the first try. It all depends on what your diagnosis is, what treatments you've already tried and if you've had more than one dr give the same recommendation for a hyst as treatment.

Your best best is to call your insurance directly and ask them if it's covered and under what conditions. Good luck!

Loz