| Stage | Ask the practice to identify | Ask the insurer to resolve |
|---|---|---|
| Before the operation | Consultation, blood tests, imaging and specialist assessment. | Which diagnostic and examination charges are eligible? |
| During surgery | Procedure, anesthesia, implants and any meniscal work. | Does the eligible-expense wording include these charges for this diagnosis? |
| Early follow-up | Rechecks, medications and additional imaging if planned. | Are recheck examination fees treated differently from treatment? |
| Rehabilitation | Clinician-directed therapy and its anticipated schedule. | Is a separate therapy option required, and is there a cap? |
| A changed recovery course | An updated estimate if the care plan changes. | How are complications or additional treatment assessed? |
Have the clinic separate included package charges from separately billed services. Do not count a bundled recheck twice. Ask what the estimate excludes and when you must authorize extra treatment. ACVS identifies postoperative care as important, but the clinical need for a service does not itself make the service insured.
Other policies organize them differently. An eligible operation is therefore not a blanket approval of every recovery charge.