Insurance approval question...

Hi, I was wondering about something. I went and had my seminar and consult last Tuesday. They told us at Dr Shinas office not to call them back for 14 days and not to call the ins co for 30 days. People on here keep telling me to go ahead and call the ins co to see if they can give me a reference number or a case number yet. Do u think it would hurt my approval process if I called them? I am sitting on pins and needles waiting until the drs office said I could call and when someone here suggest I go ahead and call, I am ready to jump on it. I am just scared I will hurt my chances for getting approved..Let me know what u all think...To call, or not to call, that is the question...lol God Bless Angela Russell

i originally started out with Dr. Shina. The staff was really slow. had not turned in for my insurance approval two months later and that is why I went with the Lexington group. But, back then, Dr. Shina was in the rightway program and they had a website where you could check on your stuff everyday after the first couple of weeks. The one in the office named Glennda is really rude. They hate it when you call. I know you are anxious but it won't help you to call .they will do it when they want to on their time frame and calling the insurance this early will be a waste of time.

Thank u, Delores, for your reply to my post. I don't know the staff well enough yet to guess about how they are. The ones I met at the seminar seemed nice. I know Glenna has a very hard job dealing with the insurance co's and impatient people like me. It was just a week ago today that I went to my seminar. I loved Dr Shina, my husband did also and we are going to stick with him cause he is my first pick and the one I feel most comfortable around. Thanks and God Bless Angela

Angela, I liked Dr. Shina too. He is a wonderful doctor. I just couldn't deal with the office staff and, because I was what they call, "a redo-redo" meaning i had bypass surgery 25 years ago and had a reversal, he turned me over to Dr. Geller who was supposed to do it but turned out, I would have been his first rredo and he just didn't know how or even want to do it. He scheduled me for the EGD which he did and it was awful. I was awake, then two months later he still hadn't turned the papers in. At that time, they had a man in the central office that did the ins.(this was before Dr. Shina dropped out of the Rightweigh programs) and he kept telling me that he hadn't heard anything from Dr. geller. You will be fine with Dr. Shina. Good luck on your insurance approval.

Ty, Delores. I don't think I would have stucked with them either. Sounds like u had a hard deal. I enjoyed reading your profile last night. It was very interesting. Have a good one. God Bless Angela Russell

Hi Angela I don't know why Dr Shina's office told you that, but I would go ahead and call the insurance. As a matter of fact, I called my insurance co yesterday, and they told me my case is in medical review and they gave me a reference # and told me to call back on the 18th. I don't think it's gonna jeopardize your case if you call, and I'm sure it'll make you feel much better. Linda

Hi, were u at the seminar on Oct 5 with me? U look familiar. Glenna came out after Dr Shina did the seminar before they took us back and said that the ins co's prefer we give them 30 days to get the info and review it before we call. Then she went on to say we should wait 14 days to call her, but I called my ins today and they so far have nothing on me. So I called Glenna today and left her a message since it was Tuesday and she was in the Ky office with Dr Shina for a seminar and consults. I hope to hear from her Thursday cause her voice mail said something about she did not answer calls on Tuesdays and Wednesdays I think. I sure hope to hear Thursday that she has sent it in....Thanks for your reply God Bless Angela Russell P.S. If u were there last Tuesday, I was with my hubby, he has dark hair and a big mouth! lol, he is the one who said "What about sex, Doc?" like a big idiot right in front of everyone, I was so embarrassed...

Ty to those of u who have replied. I did call my ins co today and tehy said that its fine for me to call anytime I want to. As of today, one week from my seminar and consultation, they had not received anything. I called Glenna at Dr Shinas office, she is the one who handles this. I left her a message because today she was with Dr Shina doing a seminar and consults..I hope to hear from her Thursday as to when my paperwork will be sent in. Thanks and God Bless Angela Russell

Linda, I had heard from a friend of mine at work that Humana was approving the surgeries on an appeal. This is what one of the Humana nurses told a friend of mine. I had the Center for Weight Loss Surgery at St. Joseph resubmit my information again. I was denied again of course because of the exclusion. Did you have your PCP submit a letter of medical necessity? Do you think that will help you get approved? If there is no way around the exclusion, I may be out of luck. I can't afford to pay for it and I haven't found anyone who will do payment plans. I currently don't have any medical problems, but I am "AT RISK" for heart problems, diabetes and other things. I REALLY want to have this surgery bad. I just wish that the insurance would pay for it. It will save them money in the long run anyway. $20,000 for this surgery is better than well over $100,000 for heart surgery. Please let me know of any helpful information that you get. My work email address is [email protected]. Thanks!!