Re:insurance letter & seeing more than one surgeon pre-op

October 13, 2001

Carole,

When you make your inquiry with the insurance company in two weeks, I would

just mention to them that you are 53 not 52. The doctor's office made a

typo. Remember to keep your conversations to approval or not based on the

letter. I would not go discussing the procedure with them at all. Let the

doctor talk in medical terms to them (in the letter). I don't know about

switching doctors but I would guess the approval is for the procedure not the

doctor, so what your policy covers would not change by switching doctors. If

you decide to switch, I would just show the other doctor copies of everything

and they may be willing to go with it.

Dawn--South Suburban Chicago area

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting

October 13, 2001

> Carole,

> I would not go discussing the procedure with them at all. Let the

> doctor talk in medical terms to them (in the letter).

Carole,

I second what Dawn says here. My surgeon (Dr. Anthone) wrote the DS

up as a distal roux-en-Y with gastrectomy. It is technically almost

correct. My " approval " letter lists that the requested surgery is

approved and then on the same page states that the DS will not be

covered (I have Aetna). If I made the mistake of mentioning that I

was getting the DS, I could have blown Dr. A's cover (so to speak).

Let your surgeon handle things at least for the first round. Refer

to you surgery in vauge terms that are non-medical or let them call

it a " gastric bypass " (though it is not). Make sure that the paper

gets from Dept. A to Dept. B intact. I lost a month because my

request was " lost " between departments (alegedly).

Hull

Recommended Posts