Why Does the Insurance Process Take So Long?

December 19, 2012

The insurance process can vary between patients and insurance companies, but rarely is the process a short one. Most patients can be pre-approved for bariatric surgery within a matter of a few weeks, but there is no guarantee. The time waiting for the pre-approval does not have to be wasted, however. After your first consultation, you will learn more about the things you can do before surgery to make the whole process a lot easier. You can begin your diet and exercise regimen, stop smoking and start your full pre-operative testing and general health work-up. By the time you receive the insurance company’s decision, you’ll have completed many of the prerequisites for surgery.

What can you do to shorten the wait?

Ultimately, the time it takes for the insurance company to review your file is caused by the sheer volume of requests they receive. To help them help you consider the following:

Be organized…that’s about the best advice we can offer. Once you’ve attended one of our seminars, we will advise you to start the process with a call to your insurance carrier. You’ll understand exactly what you need to qualify for surgery. Further, our billing staff will assist you by performing a preliminary verification of insurance benefits.

Once you understand what documentation is expected of you, compiling it quickly, but thoroughly, is paramount. Remember, if your pre-approval is denied for any reason, even just an omission, it could take weeks to have it revisited and overturned.

What do you do if you’re denied?

We will help you in any way we can to ensure that your pre-approval and coverage is not denied. Sometimes, however, patients will receive a denial anyway. This is when you should first contact your insurance provider and request the denial in writing, with the reason clearly stated. Second, bring this denial to our billing department and we will help you analyze it and submit a response or appeal.

Unfortunately, we can’t do much more than wait for the insurance company’s decision. However, being prepared with our application for pre-approval and coverage is a great start. You may also want to attend one of our monthly bariatric surgery support groups and find a patient who has your same insurance. You may get some information about how they managed the process and the time it took for them.

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Advanced Surgical Associates is one of the first exclusively surgical groups practicing in Union County New Jersey. And that is just the first of many firsts for ASA. For over 40 years, we have pioneered breakthrough surgical patient care in North Jersey in both general and weight loss surgery. ASA also offers gastric bypass, gastric sleeve and gastric banding to those suffering from obesity in New Jersey.
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