So sorry to hear this! Are there other hospitals and doctors to use? Like someone else said it is a lot easier to swithc doctors than Insurance.
Good luck, don't give up!

Thank you everyone! You all got me thinking that I really needed to make some calls. The first thing I found out was that t he other hospital here in Hawaii does take my insurance, however, they have some out of pocket fee's (same as the other hospital group that I worked with and paid already) that you pay for the different psych, nut, and dr. pre-op visits. Considering that the original fee of $400 is nonrefundable I don't think I want to fork over another 400-500 fee to the new facility.
So...I got on the phone with my insurance company and they tell me that this proceedure has to be pre-approved to be covered. I tell them I already got authorization and that is why i've done everything already. The guy says I should have the hospital call the insurance to verify. I tell him that the hospital has already been in contact with them and thats why they are now saying my insurance is not covered at their facility. He then tells me that he had not heard of this and needs to look into it further and will get back to me! UGH! I'm hoping they call soon.

oH ALSO...WHAT IS "GRANDFATHER IN"?

Usually the preop requirements include EKG, labs etc. the majority of other requirements - psych eval, nutritionist visit etc come from the insurance company. If you've already done the EKG, it should be good for 6 months and your labs for one. I'd call your insurance company first and have them help you find a hospital since they've already approved you. Switching insurances will for sure get you different criteria to be approved. I work in healthcare and this has always been my experience with WLS.

No Way!!!!! This kind of stuff burns me up.

I think you should find a new Doctor.

If you absolutely need to find a new insurance, make sure they don't have a pre-existing clause. Some insurances that have that can make you wait up to 18 months before they will cover pre-existing conditions.

Best of luck to you!
Shelley :o)

This really stinks, they should have notified you way before that this was going into effect. They also should refund you the money that you've already paid for services that they are no longer going to provide to you. If you keep the same insurance the Preop requirements should not be different no matter which hospital you go to. Your Preop testing and labs can be transferred to your new hospital at no charge to you under the continuity of care rules. Good luck

I'm glad to hear you are making those calls! Maybe the other hosp will take the information from the evals you already had done so you don't have to re-pay! Or, if that guy goes digging, he will hopefully find what it needed for approval... Don't let him off the hook! Call him back in a few days... Also, be sure to record who you talked to and when. A littel CYA never hurts!!

Also, grandfathered in is basically saying that they do not drop you because you had already started the process. Maybe they don't take on new folks with your ins, but they should keep caring for you because you are already so far into the process. In a nut shell it mean the new rules do not apply to you because you were an established patient before they came into effect. Hope that makes sense! Keep us all in the loop on how it goes!

Thank you Becca for explaining that to me. I havn't been able to get any concrete answers yet. I had my PCP receptionist call my insurance and they said they still work with Queens and in fact they have doctors who work in that hospital. So I called the hospital again and the lady said that its their bariatric department that no longer accepts my insurance. It still makes no sense. So I have an appt with my PCP this afternoon to go over the stress test results (they are still freaking me out) and talk to her about this insurance fiasco! Hope to leave with some information or even better...some good news! :)