What Can I Do?

TropiGal R.
on 5/17/07 5:14 am - Milwaukee, WI
Urgh!!!! I am so frustrated.  My request for pre-authorization was initially sent to my insurance at the beginning of January.  The insurance denied...stating that I needed to do a 3 month Physician supervised weigt loss program.  They furthur stated that once I finished the three months, surgery would be "medically appropriate".  My PCP started seeing me immediatly for my monthly appts.  We finished that step on April 9th.   All my documentation was faxed to the insurance company April 23.  My policy states that they must give me an answer in 15 calendar days...it has been 25 calendar days! I call almost every day-I am told the doctor is STILL reviewing it. What can I do-my policy says 15 days maximum-but I keep waiting. (The policy is self funded through my husband's company.) Any suggestions?  Ideas? Thanks!!! Lisa  

Lisa R.

gary viscio
on 5/17/07 6:41 am - Oceanside, NY
Patience, it stinks, but you're at their mercy right now.  I'm sure it will be fine
Gary Viscio
www.ObesityLawyers.Com
RNY 7/1/03  -166lbs
TropiGal R.
on 5/17/07 9:03 am - Milwaukee, WI
Gary, Thanks for your support.  I called thge insurance and mentiobed that they were supposed to respond within 15 days.  A little while later a manager called me to apoligize-and tell me I am APPROVED.  Yeah!!!!   She said it should only have taken two days-and would check into where the system broke down.  I told her who I was working with there-who I spoke to almost daily and who kept putting me off.  She was not happy.  The company is simply an administrator-and they were showing really poor customer service.  Anyhow, I am approved-and my surgeon's office wil schedule the surgery tomorrow-but they told me I can pencil in the beginning of first full week of June-just over two weeks away! Lisa

Lisa R.

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