I’m seeing an in-network surgeon next week for a specialized procedure, and the surgeon’s office checked with our insurance (United Healthcare) and said that no prior authorization is needed because the surgery is being performed in the state of Wisconsin.
However, when I called a UHC member representative, they said that all they can see is that prior authorization is needed for those surgical codes in general. They said they are unable to see specific details for the state of Wisconsin, though, because they are a member representative and not a provider representative.
I’m traveling across the country (I’m in California) for the surgery, so I’m very concerned that maybe everything needs to be postponed if prior authorization is indeed required. I want to trust the surgeon’s office that prior authorization is not needed, but I’m just concerned.
So how can I (the patient) verify whether or not prior authorization is actually needed, if I can only talk to member representatives who can’t see the details that a provider representative can? Do I just have to trust the surgeon’s office?
Thanks for any info!
submitted by /u/phoenix523
[link] [comments]
I’m seeing an in-network surgeon next week for a specialized procedure, and the surgeon’s office checked with our insurance (United Healthcare) and said that no prior authorization is needed because the surgery is being performed in the state of Wisconsin. However, when I called a UHC member representative, they said that all they can see is that prior authorization is needed for those surgical codes in general. They said they are unable to see specific details for the state of Wisconsin, though, because they are a member representative and not a provider representative. I’m traveling across the country (I’m in California) for the surgery, so I’m very concerned that maybe everything needs to be postponed if prior authorization is indeed required. I want to trust the surgeon’s office that prior authorization is not needed, but I’m just concerned. So how can I (the patient) verify whether or not prior authorization is actually needed, if I can only talk to member representatives who can’t see the details that a provider representative can? Do I just have to trust the surgeon’s office? Thanks for any info!
submitted by /u/phoenix523 [link] [comments]Read Morer/HealthInsurance