Question:
Have any of you tried to change surgeons after ins approval?

Have any of you tried to change surgeons after ins approval? If so, did you have to go through the entire approval process again?    — Kimberly S. (posted on March 6, 2003)

March 5, 2003
I havent - BUT I was thinking about it; and called my Insurance company. They told me ITS the proceedure that is 'approved' basically NOT the doctor - So, if you want to change doctors you can... BUT if like me are in a PPO , to get the max benefits I still needed to 'stay' in network. But the insurance company had no problem - they just told me to be sure the new doctor submitted his paperwork with the 'SAME" procdure codes....
   — star .

March 5, 2003
In my case, YES, I tried to change surgeons after approval, and was told I would have to go through the entire process all over. I think it probabaly just depends on your ins. co., and maybe even WHO you talk to. My ins. co. is not the greatest, and the woman I have had to deal with throughout this has been a real B*T*H!!! Having a PPO didn't mean squat in my case, but it sure doesn't hurt to at least try. Good luck!!
   — Cat S.

March 5, 2003
I changed doctors after my approval, all the doctor had to do in my case was send a letter to my insurance company stating they he was taking over my care and wait for the insurance company to reply with an approval of the doctor. It took two months because the receptionist at the doctors office didnt mail out the letter until almost a month later to the insurance company. I was a little ticked off about that. But i got approved for him to preform the surgery.
   — rachel W.

March 5, 2003
I know of someone on this site that changed doctors with zero problems. The surgeon she was scheduled with wanted $5000 up front and she did not have it. She could not get her insurance company to say yea or nay to the surgeon charges as far as being fully covered. If it would have been fully covered she would not have needed the $5000. So 2 days before her surgery she had to cancel. She then contacted the place that did Carnie Wilson's surgery and they took her insurance and faxed a lettr right away and within a few days it was all changed over and she only ended up with a few week delay in her surgery and then she also didn't have to have all the blood work redone etc. They really worked hard to get her scheduled right away. She still had to play an amount up front but it was much less and doable. I think it will vary from insurance to insurance but I certainly would argue why does it need to be completely reviewed again if the new surgeon is doing the same procedure. Make sure which procedure they are doing is in the letter to switch surgeons.
   — zoedogcbr

March 5, 2003
I changed surgeons without a problem. I "interviewed" a few surgeons and each took it upon themselves to seek surgery approval from my insurance carrier - - even after I told them I was shopping around! When I decided on the surgeon, I made sure all the paperwork from the insurance company correctly listed the surgeon I chose. As it was mentioned in another post, it's the procedure that is approved, not the surgeon.... but, you want the paperwork to reflect the correct person. Good Luck!
   — teresa M.

March 6, 2003
I have Empire BC/BS PPO. When I changed surgeons, all I did was call the case manager for my approval and give the new surgeon's information. My new surgeon's office had called as well. There was no problem at all.
   — [Deactivated Member]

March 6, 2003
I changed surgeons after I had approval and even a date scheduled because my surgeon wanted $4500.00 up front and decided to not accept my any networks. I scheduled with a new surgeon a few weeks later and just took my original letter of approval with me. They scheduled my surgery that day and just called my insurance company to get switched to them . I had no problems. Kelly
   — Kelly B.

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