Do you have insurance approval yet?

Hi,

My doctor has scheduled my surgery for 10 days after we decided to do the hysterectomy. He tells me that even though they will continue to call the insurance company that most of the time they don't get insurance approvals until the day before the surgery, even when there is more time than the 10 days.

Have you had this experience too? My doc said there's a small chance that my insurance company will want me to go through a D&C before the hysterectomy (to prove that the cervic is going to close right back up again too tightly to menstruate), which I would appeal. No need to go under a general anesthesia 2 times, when you know you need the hysterectomy in the long run.

My doctor doesn't want to even consider setting the date until the HMO says that they will approve the surgery. DD hates the HMO's! I called my rep at HealthNet and she was great...I voiced my concern that they might balk at approval for my hyst. She told me that if the doctor feels strongly enough that it is needed there will be no problem with getting authorization. The rep said that the HMO understands that adeno and endo can be very difficult to diagnose, and as long as the DD makes the effort to diagnose as best as possible they are cool with it. I get my MRI done tomorrow morning. I believe that DD will want to see me to schedule sometime next week. Here's keeping my fingers crossed!

I didn't get my approval until the day before, either. I called the doctor's office and said, "Okay, I'm about to do the bowel prep, so you'd better tell me I'm approved!"

And I was.

still waiting for my authorization...this is the first time with a ppo that I have had to deal with a auth. Had message to call dr. when i came back from lunch, got all excited and thought it was auth. & date...nope. just called to tell me a mistake was made and dr. is not on list of providers so that I am looking at a min. of 1800 bucks to go ahead..ofcourse TEARS immediately, but called dh, and he said he did not care to tell them to go ahead and get this thing over with and get me back to normal and to where i like everyone again! So I guess I am still waiting, but I think they are going to go ahead and schedule it without the auth..

I just found out today that my insurance (Healthnet POS) is questioning the hysterectomy. They faxed a form for my dr. to fill out with more medical history. He dictated a letter that will be faxed tomorrow. Hopefully we'll find out by Monday, because I have my pre-op appt. with the doctor and the hospital on Tuesday with surgery on Friday.

My insurance (HealthNet HMO) was already approved when the doctor's office called with my date. The surgery date they gave me was 6 weeks later! My diagnosis was fibroids which were huge and since my GP found them then referred me to the gyn maybe that counted as a second opinion. I definitely thought there would be more of a problem with the insurance.