By Tom Murphy, AP Business Writer
Paying for surgery these days requires more than pulling out your insurance card and hoping for the best, even for those with good insurance. Doing a little homework can help you save money in some cases and avoid surprises when bills arrive in the weeks after a procedure.
Here are some things to consider before checking in to a hospital or outpatient surgery center for non-emergency care. Be prepared to ask your doctor or insurer questions.
Will your procedure be covered?
Insurers won't automatically fork over a payment just because you're wheeled into an operating room.
They'll pay for plastic surgery if you need breast reconstruction after cancer surgery, but they often pass on covering purely cosmetic procedures, even if the reason for the disfigurement is an accident or medical procedure.
Also, some spinal fusions are considered investigational or experimental, said Kevin Flynn, president of HealthCare Advocates Inc., a for-profit company that helps patients with debt resolution and insurance disputes.
"What it means is the insurance companies aren't going to pay for it because the insurance company doesn't believe in it," he said.Your doctor should know about the insurance coverage, but it is advisable to double check with the insurer.
Is preauthorization required?
A doctor's office also should know which procedures or surgeries need preauthorization from the insurer before they're done. Often, they take care of getting that for you.
But it is best not to assume. Better to make a quick phone call to confirm with your insurer. Note the date and time you called and get the identity of the customer service representative who helped you.