stupid insurance companies

[Guest guest]

Hey, Jerry.

As long as they approved CPT code 43847 as the primary procedure

(sometimes 43633 secondarily), I don't think that you need to go any

further with this. My stupid insurance company STILL doesn't know

exactly what my surgery was (a long story not worth getting into)!

>

> Hey Guys and Girls,

>

> I may have FINALLY gotten approval for surgery! The lady who read

the

> approval to me over the phone did not even know what she was

talking about.

> Even the doctor's office could not understand for sure which

surgery they

> had approved...RNY or DS. So, we have to wait until we get

the " official "

> letter to find out exactly what I've been approved for. But, they

did

> by-pass all the " necessary criteria " and decide that in my case

gastric

> bypass is medically necessary! So, half the battle is won! But, I

have a

> question...is it possible to self-pay the difference and have DS

instead of

> RNY? My doctor does both surgeries and I refuse to have RNY. My

PCP also

> believes that I should have the DS and not the RNY. So, we can

fight that

> battle if we need to. However, as of January 1, my insurance is

making some

> MAJOR changes in deductables and out of pocket expenses. So, if I

could

> self pay the difference and have my surgery before the 1st and then

appeal

> the amount that they pay...get the idea?

>

> Jerry, Southern Gal from LA...

>

>

> _________________________________________________________________

> Get your FREE download of MSN Explorer at

http://explorer.msn.com/intl.asp

[Guest guest]

,

Thanks for the info. The girl who phoned to tell me the " good news " (I've

been trying since Feb!) read what they approved and she read that they found

RNY gastric bypass medically necessary but not the hand assited Lap...and

something else with a " D " that she could not say...so, we're just not sure.

I have understood from previous posts that sometimes RNY is used to refer to

the bypass part of the surgery and not the " stomach " part. Hope so!! If

that is so and we can " slip " the DS by them...the docs office said that I

might be able to be schduled the week between Christmas and New Years!! I

might could be schduled before but my husband and I own a small Christian

Bookstore and Gift Shop....can't really take off any in December...big

selling season! So, we are really pushing to get in that last week of Dec.

Hugs (Still fluffy)

Jerry

>From: mkf5t@...

>Reply-To: duodenalswitch

>To: duodenalswitch

>Subject: stupid insurance companies

>Date: Sat, 01 Dec 2001 19:28:59 -0000

>

>Hey, Jerry.

>

>As long as they approved CPT code 43847 as the primary procedure

>(sometimes 43633 secondarily), I don't think that you need to go any

>further with this. My stupid insurance company STILL doesn't know

>exactly what my surgery was (a long story not worth getting into)!

>

>

>

>

> >

> > Hey Guys and Girls,

> >

> > I may have FINALLY gotten approval for surgery! The lady who read

>the

> > approval to me over the phone did not even know what she was

>talking about.

> > Even the doctor's office could not understand for sure which

>surgery they

> > had approved...RNY or DS. So, we have to wait until we get

>the " official "

> > letter to find out exactly what I've been approved for. But, they

>did

> > by-pass all the " necessary criteria " and decide that in my case

>gastric

> > bypass is medically necessary! So, half the battle is won! But, I

>have a

> > question...is it possible to self-pay the difference and have DS

>instead of

> > RNY? My doctor does both surgeries and I refuse to have RNY. My

>PCP also

> > believes that I should have the DS and not the RNY. So, we can

>fight that

> > battle if we need to. However, as of January 1, my insurance is

>making some

> > MAJOR changes in deductables and out of pocket expenses. So, if I

>could

> > self pay the difference and have my surgery before the 1st and then

>appeal

> > the amount that they pay...get the idea?

> >

> > Jerry, Southern Gal from LA...

> >

> >

> > _________________________________________________________________

> > Get your FREE download of MSN Explorer at

>http://explorer.msn.com/intl.asp

>

>

>----------------------------------------------------------------------

>