Seriously about to pull my hair out!

geutenmorgan
on 4/22/11 11:02 am
I am so frustrated!!  I should have a surgery date by now and it still hasn't happened. I already had a Pre D from my insurance for the RNY, but upon learning about the DS, decided to change to that surgery.  That involved changing surgeon... Fine found a great surgeon that I really like.  When I met with him on MARCH 15th I had all my paper work needed along with the Pre D letter from my insurance.  All that needed to be done was changing the type of surgery and the name of the surgeon with my insurance.  Unfortunately the insurance girl was on Vacation.  fine I will call the next week, so I did, she told me to wait to follow up on April 1st, by then we should have an answer. So upon calling April 1st I got a lot of not heard yet.  Okay, waited a few more days still nothing.  Then called the next week... the insurance lady I spoke with no longer works there.... and the guy I talked to acted like a fish out of water and had no idea what to do.  All I heard was uhhmmms and paper shuffling. Told him what needed to be done, said I would follow up in 2 days.  In the mean time I called my pre cert insurance people they state they have heard nothing of the changes yet.  Really cause it was suppose to have been dealt with a couple weeks ago.  Then call a couple days later to surgeons office cuz the guy was suppose to call me back and never did, got a nurse practitioner on the phone, told her I was frustrated she seemed like she was able to help... but we are still with nothing.  the guy then said on a later call it is the waiting game we just have to wait.  I wouldn't have a problem waiting if it was on the insurance going through the processes, but it isn't, it is still this office not getting the act together, cuz now their new insurance person is on vacation and should be back on Monday.  My pre d with my insurance is still the same as it was on March 15th.  Now my husband has lost his job and we are going to have to COBRA at $1300 a month so I can get this surgery.  I am sooooo frustrated!  What should I do???  How do I get this office to complete the task and get it done?
pycca
on 4/22/11 11:25 am - Haslet, TX
They have an outside company that submits now, So even office is at mercy of the processing of the  requests.

I would call back and get the contact person at the company if Matt does not know of status,

Then I would contact  whomever it  was sent to stating of the prior pre cert and this is a change of type of surgery but still WLS  under the cpt code. Then elaborate to anyone and everyone that  time is of essence !! LIL

Good luck !
    
Ann M.
on 4/22/11 12:56 pm - GA
Is there an office manager that you can speak to? I would make sure to underscore the criticality of the timing here in that you are about to have to go on to COBRA. Otherwise I would follow Pycca's suggestion and start calling myself. I feel your pain but be persistant because in your case time really is money!

 

-Band to DS revision on 06/21/2011!
Highest known Wt/ Lowest Wt (Banded)/ Regain-Starting Wt/ Current Wt/ Goal Wt
379.6/ 272/ 342/ 169/ South of 200

 

KimberlyHeidi
on 4/24/11 12:03 am - VA
 Totally agree with this. Good luck! 
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