Author Topic: filing insurance claim through PS  (Read 2325 times)

Offline wasatchm

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hi,

need some help.  I have several appointment with PS regarding gyne surgery.  if I have one of these plastic surgeons file a claim for insurance coverage (AND DO GET INSURANCE COVERAGE for the surgery)  is it expected that I will have him do the surgery?     or, should I see all the PS I plan to see,  pic one to do the surgery, and then ask if he will file a claim for insurance coverage.  I have decided I will have surgery regardless of whether insurance will cover it or not.  

what is the best approach to  take in filing for insurance coverage.  I do not want to commit to any one PS till I am sure he/she is the right one for the job.

thanks

BA

Offline jc71

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  • Wilma, grab the lotion, we're going to the beach!
they don't approve based on what ps you use.  so first find out if they'll cover it and then decide on the ps.  you're not obligated to use that ps

Offline wasatchm

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I didn't mean to give the impression that insurance may or may not cover based on the plastic surgeon I choose.  however, I did call member services of my insurance to find out if insurance would cover gyne surgery.   I thought I could take some pictures, fill out some forms send them in and get a response.  she said I would have a surgeon file a claim to see if insurance would cover it.    I was surprise to say the least.

Offline wasatchm

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I did also talk to another PS today (he also happens to be a professor of plastic surgery at a local university).  I told him what HMO plan I had and with what insuranc company.  he told me,  I would need to have a primary care provider (plastic surgeon) on my HMO plan file the claim for insurance coverage.  I check, and there are only 13 Plastic Surgeons on my HMO plan.  of them, I have no idea how many are experience with gyne surgery.  wish I had a bigger pool to choose from.   guess that's the choices I get for being in an HMO


 

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