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Question about insurance approval Question about insurance approval

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Unread 11-20-2006, 10:18 PM
Question about insurance approval

I have been reading posts about insurance denying authorization for the hysterectomy until other things are tried etc. It makes me wonder what the deal is. I called my insurance company and they were very blaze about the whole thing. They just told me that I automatically was approved for a 4 day stay and if more was needed then they would have to call for approval. But I didn't have to submit anything etc. for approval or not approval. I am assuming that my doctor's office has already done this? It seems so transparent to me and so since I haven't heard much am just wondering how you all knew so much about what was approved and what isn't. Thanks.
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Unread 11-20-2006, 10:27 PM
Question about insurance approval

Mine was approved without a hitch as well with the first request from the Doctor. They only approved me for one overnight stay but the hospital got me approved for a second overnight while I was there. I went to see 5 Doctors before I selected one to do the surgery and three Doctors included in their insurance claims for my office visits that I needed a hysterectomy and the reasons why. I sort of overdid the second opinion I suppose but if it greased the way to an approval, yippee because it's a done deal now.
Unread 11-20-2006, 10:30 PM
Question about insurance approval

It's so weird how there doesn't seem to be any particular rhyme or reason for how many days and what is approved or not approved. My doctor never even talked about insurance to me. I think I will ask them tomorrow in my pre op. Just curious more than anything. Thanks.
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Unread 11-21-2006, 06:22 AM
Question about insurance approval

I think that sometimes when it isn't approved at first is because the insurance company wants the person to try less invasive procedures first. Second opinions are another thing that sometimes helps with getting approval - and a really good idea anyway

I had already gotten a couple of extra opinions and had some procedures done & my approval was pretty quick. I was preapproved for 2 days. I ended up having to stay two extra days and the insurance paid for them too

Best wishes with your pre op.

Unread 11-21-2006, 06:30 AM
Question about insurance approval

My doctor was concerned that mine wouldn't be approved by my insurance company due to my age. We were ready for a battle, but my insurance company didn't give us a hassle.

I do know that my doctor submitted the history behind my problems to the insurance company.
Unread 11-21-2006, 10:24 AM
Question about insurance approval

There are so many insurance policies out there. Not all require a preauthorization for surgery. If they do, things like the diagnosis and age are factors they consider. The length of stay is based on type of surgery. If one has to stay in the hospital longer, the doctor and hospital request an extension.

When we have insurance questions, we need to remember that there is not a "one size fits all." The only people who have the exact same coverage as you are the ones in your group.

Unread 11-21-2006, 11:00 AM
Question about insurance approval

I remember feeling a little freaked out that my insurance company had approved me for a hysterectomy while I was still wondering if I had made the right decision! The authorization did seem awfully quick and easy. But, looking back, I am glad that there was no hassle, and I choose to believe that they simply trusted my doctor and her opinion. Once I was in the hospital, I felt that I had final say (within reason) as to how long I wanted to remain there. Sister, don't waste your time worrying about this. It sounds like you have good insurance coverage and that everything will be taken care. Your doctor and his/her office staff should be able to answer any insurance concerns you have. Best wishes.

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