Not sure what to do

danvet
on 10/27/11 11:07 pm
 I'm at the point now where the office coordinator returned my e-mail regarding my questions about if she received my paperwork and how will I know when my information was submitted to the insurance company.  

She replied with the following:  I will be reviewing your paperwork tomorrow (Thursday), if everything is in order it will be sent to insurance for approval, I will let you know.

I don't want to be a pain and bug the office, I am not the ONLY patient though I feel as though I am, and I really understand that she has many patients and that everything is probably going in order of received most likely.

So instead of bugging her I called the insurance company to find out if my information had been submitted to them and was told that the approval department has to work off of what comes in on the fax machine in the order of what comes off the fax machine and that it can take 7-10 days for them to refect that the paperwork has been received to be updated in the computer system.  I have Anthem PPO by the way.

I really have to admit that of all the things I've done, this is absolutely the very hardest time ever.  The wait is killing me.  Does everyone feel this way?  I'm thinking I should just put it out of my mind and see what happens.  Maybe get busy with work and forget I've even got this going on (ok, that's not going to happen).  

Hoping that everything goes well and I get my approval I am so desperately seeking!!!  Wish me luck.
Raynae S.
on 10/27/11 11:12 pm - PA
I know its hard but I would wait till Monday and give them a call. If you can't wait then do at the end of the day today! I know I was a pain in the butt Good luck, I hope you get approved!!!
                    
SashaDY
on 10/27/11 11:20 pm
I called every day.  Sometimes twice per day.

I am of the feeling that you must make things happen....

It is their job to help you.....get approval AND feel okay about things......

I called the insurance company, the office, the surgeon, the hospital.  All of it.
Day_dream_believer
on 10/27/11 11:38 pm
Give it several days before you start to get concerned.  Both the office coordinator and the insurance company have given you an answer.  She will let you know if there is a problem.  I wouldn't expect an answer by Monday, but you can always shoot an email to your coordinator on Monday asking if everything was in order.  Keep busy, read a book, and try not to obsess.  I know easier said than done. 
        
Sunbunnyqt
on 10/28/11 12:19 am, edited 10/28/11 12:20 am - FL
I waited a week before I called my pre certification department of my insurance because that's what my surgeon's office suggested. BCBS did not have any indications that the claim had been submitted. Then I called my surgeon's office and they assured me it had been submitted. I was very exasperated but I really think that the surgeon's office was being untruthful. I think they must of faxed it again. I would ask your insurance if a case number has been assigned and if not I would ask for the call reference number generated by your inquiry. It gives you some specifics that you can talk to. I hope it does not take long. The strange thing is that faxes are flying all over the place with supposed "confirmation" - I wonder where all this HIPPA protected information is going.

               
        

CarolBeth
on 10/28/11 12:21 am - SoCal, CA
I have Anthem PPO as well and had no problem with approval.  It DID take a really long time, but I guess I was ignorant enough at the time to just believe my surgeon's office when they told me they never have problems getting approval from Anthem.  I was sheduled for surgery WAY before the approval came through.  That approval came through only two days before my surgery!  I'm sure all will be well for you, too.
Carol - RNY July 11, 2011
          
antywawa
on 10/28/11 2:40 am
Hi there, don't worry about calling everyday the more you call the more they will do there job. I worked in doctors offices and if you get someone who is not very good at getting authorizations then your approval can take forever. Once they send your request in and make sure it has been sent then you should her something within the next couple of days. Insurance companies really don't take that long to authorize or deny things. I suggest you keep on bugging until they get tired of hearing from you. As long as all of your paperwork is in order there should be no reason why they will deny you. Good luck and hopefully you will hear something soon.
    
danvet
on 10/28/11 4:07 am
 Thanks for the advice.  I am a nurse but don't work in a MD office but as a case manager in home health.  You would think that I know these things and I really never get annoyed when patients call repeatedly, but the last thing I want to do is to annoy the person who is going to help me obtain that authorization I need.  

I'll wait until Monday afternoon and then check in again.  I guess it shouldn't be much of a bother because my doctors patients are required to obtain their medical records so they can be faxed to insurance.  I ran like a crazy person.  I attended my first seminar 9/28 and I am a month to the day now.  I guess I should be grateful it's gotten to this point so far!

Thanks.
(deactivated member)
on 10/28/11 2:58 am - Santa Cruz, CA
Just be sweet and kind; they don't like being chewed on any more than you would. "More flies with honey than with vinegar" sez my little ol' Okie Mom.
(deactivated member)
on 10/28/11 3:01 am - PA
 I had a similar problem was told for three weeks my pers were sent in called after two weeks and got done walled, then in the third week I called insurance they told me if my papers had come in it surely would have been processed by then, they checked the fax machine just to be sure and it was not there, the gave me a special number for my docs office to call and I called them back and she forwarded it to the lady who does tha papers and I kid u not my drs secretary called me the next day to tell me they received my approval and wanted to schedule my surgery. 

I went for it because to most drs we're just money, they'll get paid eventually, I wanted my surgery really badly and knew if I didn't do the pushing it would take longer than I wanted it to, so if u wanna make some calls go for it.  I'm two weeks out and looking back I would have made that call again even tho I annoyed them. 
Most Active
Recent Topics
×