Insurance pre-authorization question

[jtludwig]

Quick question about insurance pre-authorizations.

I am a 30 yr old scheduled for AVR and root repair at Massachusettes General Hospital next week. I called Tricare (my insurance company..I'm in the Air Force) today to see if they had received anything requesting authorization for my upcoming surgery, and they replied that while they could see my previous consultations with the surgeon, they saw nothing from the hospital requesting authorization for the upcoming surgery. Needless to say...I was kind of surprised. I called up the insurance department/admissions department at Mass General and they assured me that they do the request for authorization 5 days out from the surgery date and that this is standard practice. I even called back a few days later and a different person told me the same thing.

What has been your experience with insurance pre-authorizations? I am just nervous that the surgery will be delayed because of some insurance snafu..and I can't handle a delay. The lady at Mass General told me not to worry..but I am still a bit nervous.

Thanks

 

[kfay]

I was just like you, nervous and worried when I realized that the insurance company said they had not authorized it a week or so beforehand. After a couple of phone calls just like the ones you have made, I realized that I just had to let it go, that the hospitals do this all day long and they were not going to do it for free. When I checked in on the day of surgery I asked once again about the insurance and they told me everything was fine and it was...I didn't pay anything out of pocket for the surgery or hospital stay itself.

 

[Luana]

My surgeon's office handled everything for me and there were no problems.

 

[swim mom]

We have tricare also (my husband just retired). I had abdominal surgery last spring and the hospital didn't request authorization until about a week prior to the surgery either. I had more problems with my cardiac clearance than I did with tricare.

 

[terodac]

The hospital is always good about gettin the info to them because they know they have to be and want to be paid! That should have been done, call your surgeon's office and I bet they get it moving for you! God Bless! Good luck! we are here for you with any question post op or pre op! Prayers!!!!

 

[jtludwig]

Thanks everyone! I checked the Tricare website again this morning, and sure enough there was the request from the hospital...it said that the decision was "pending" but I assume that is because they just received the request either yesterday or this morning.

 

[catwoman]

Glad you're feeling a little relieved now.

I've never worried about the precertification process. The surgeon handles notifying insurance & booking the hospital. Then one day I get a phone call from the hospital notifying me that it's all set and getting more information and when to report for surgery.

 

[jtludwig]

Thanks everyone! The hospital just called..said I'm all set in terms of the insurance .