Get insurance approval? or pay cash now and hope for reimb. later? help!

[nornie73]

My husband is looking at having 2 art. cervical discs implanted ASAP. We have a local northern CA HMO (which does have positive coverage for one level--may not be approved if 2 level or hybrid). In any case, he is looking at going to someone with a lot of experience (LA, Texas).

TBI has given us a firm cash quote. Should we just go ahead and pay this and get the surgery done and try to get reimbursed later? Or try to go the approval process and wait and see? My fear is that it will take forever and then be denied anyway. But if we pay the cash price does that eliminate any chance of getting reimbursed later? TBI seems to be the only one who can manage to put together a price quote.

Anyone had luck paying cash and getting a payment later from insurance? This is all so confusing...guess I need to buy the Insurance Warrior's book (if it addresses this!)

Thanks for any input.

[jss]

Nornie,

I have thus far not had luck in getting reimbursed after surgery. I'm in the process of my second appeal and do believe that if I'd done the insurance fight before surgery that I would have had a better shot at getting my carrier to pay.

Good luck, Jeff