Question:
Doctor's Insurance dept not any help, how could I help my case?

I am in the program at Vanderbilt. I began going 9/01 for screenings and such. My surgeon is William Richards. I had my pre-op consultation 12/11/01. I was told that I was a good candidate for surgery. Everything was GO! I checked with my insurance BC/BS of TN the first week of January to see if they had received my pre-determ, and the answer was no. I called Vanderbilt they gave me some story about insurance companies being slow. So I began calling BC/BS every Friday to see if the had received anything, and NO was always the answer. I would always call Vanderblit to check and let them know what they said, and I got the same ole runaround (Ins companies are so slow). On 2/6/02 I finally talked to someone who told me they would send in my files again. I called him back on 2/8/02 to follow up, and he didn't even remember it. By now I am getting very upset! I then learned the next day that my file had not been sent to BC/BS, and had never been sent...This is now two months since my consultation. The billing coordinator, Linda just happened to pick up on the phone call, and she said IT WOULD BE SENT TODAY! (This confirmed to me they had a problem) It was sent for the first time on 2/11/01 exactly two months after my visit with the surgeon! The insurance company did exactly what they promised they reviewed the claim within 14 days and then notified me by mail that I had been declined because I needed a psychological evaluation. I had sixty days to ammend the present claim. I took matters in my own hands and called Vandy and finally after some fussing got an appointment. The problem is the doctors office or the insurance department has yet to call me or send any kind of notice of what they received about my decline. It is now the second week of March, and my time is running out. I have thought about emailing the Doctor directly, sure he is unaware of the problem I am having with his incompetent subordinates!    — Cindy T. (posted on March 7, 2002)

March 6, 2002
I am having a similar problem with my surgeon's office. They have absolutely NO interest at all in pushing my case or even in actually getting up and checking on something before saying whatever they want to me when I ask a question. Of course, I get a different answer every time I speak with anyone there. One person says they did get my psych evaluation. The next day someone else claims they never got it and it's not in my file. This has been going on for months and I am about a gnat's butt away from dumping them and picking another surgeon. The ONLY reason I haven't yet is that the hospital has an excellent reputation as a major medical center and it's close to my home. I just hate to go 200-300 miles away to a much smaller hospital with less resources to get something this serious done. I really wonder though what kind of care I will get during and after surgery if this is how I'm being treated now. I'm taking everything into my own hands now and doing as much as a can on my own. I call them to bug them about things far more than I should have to and I now always ask to speak to the same person (of course she is almost never available and I have to leave a message!). Do everything you can and if it doesn't get better, change surgeons. That's my plan.
   — [Anonymous]

March 7, 2002
I am so glad to know that I am not the only one that is experiencing these problems! I finally have taken the matters in my own hands and was EXTREMELY lucky to get a SUPER nice customer service rep at BCBS of FL who listened to my story as to waiting for 2 months and made a call over to the surgeon's office for me. After giving him the same story that the paperwork had been sent already, yada, yada, he requested they fax it to him while he was on the phone with him and he would send the info to pre-certification himself. WHAT A GODSEND! You may want to try my approach and see if you can actually get someone at your insurance company who believes in doing their job right the first time! Who knows, you may get lucky like me!
   — Rachelle P

March 7, 2002
Here's something that I like to do call everyday if possible and visit as much as possible. They will eventually get tired of seeing you
   — [Anonymous]

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