Insurance Authorization Denial, AFTER scheduling surgery date

So I received a call from my case manager at my insurance this afternoon, telling me my authorization for surgery, which has ALREADY BEEN SCHEDULED, was denied due to the psychiatric eval done last JULY. Apparently the doctor, who cancelled my appointment without telling me a total of THREE times before I actually saw her, stated that I wasn't psychologically ready for surgery and needed further counseling. I am so angry, and it is Friday at 4:20 pm so I am not getting an answer anywhere I call for information. Anyone have any experience with this? Apparently I need to have another psych eval and who knows how long it will take to get that appointment.  I am already on my pre-op diet, have my leave scheduled from work, and am just so ready to have this surgery! 

I'm so sorry that is awful!

Did you not see the psych eval before now?  Or did your insurance case manager not see it before now?   That seems odd.

Do you have a copy of the eval?  If not, I would request a copy so you can see why it was denied.  I would be really mad too.

You can schedule another eval with a different provider.  Hopefully it doesn't take too long.  You can also get a copy of the report yourself before it goes to insurance.

That is was I am trying to figure out, when I finished up the appointment with her she said to me that I was "a good candidate for surgery and it would without a doubt improve my life". I took her at her word and made an assumption that she would clear me, especially since everything else in the process has moved forward so smoothly, which I now regret! I am trying to understand why no one on the insurance side seems to have looked at her report before now. 

I am requesting a copy of the report and have contacted patient relations, so if I have to have another evaluation, I hope it will be done by someone else, bc I am not willing to have that woman "evaluate" me again.

Thank you for your insight, I really appreciate it!

I would have taken her at her word, too.  That's really frustrating.  I'm sorry.

I also would request a copy of the report if for no other reason than to ensure there wasn't a mistake.  Any psych that would tell you you were a good candidate and then later say that you need further counseling prior to surgery screams mistake to me.

Wow, I'm sorry to hear that. SOMEONE at your surgeon's office should have reviewed the Psych eval!

Unfortunately, situations like this is one of the reasons that most surgeons won't give you a surgery date until they already have the insurance authorization in hand.

Get a copy of the report and push them to do whatever they can to get you a new appointment ASAP!

Lora

I'm so sorry that is so odd though my program looked at my psyc eval before even allowing me to meet with the medical director and then i had to meet with her before the approval to meet w/my surgeon i am surprised they didn't review it before issuing a surgery date and all. I am so sorry this happened to you. I hope you get it figured out soon.