I hate this waiting game

The surgeons office said they submitted everything to the insurance co on 5/9. The insurance co said they have received nothing from the surgeon's office. Indeed to get this done before July 1st I don't have the money to pay the $3,000 deductible again when I am this close. Everyone I talk to tells me something different. Why can't I just find out yes it is covered or no it is not. I have done everything required. Lost 20 lbs past the psych and all the other test. I need to get this scheduled with my employer too. This waiting and not knowing is driving me crazy. I want this so bad. Any suggestions to speed this along. I have united healthcare choice plus and they say it is a covered surgery with pre authorization. What does that mean? I am ready for an answer! Started this journey march 1st. Am I being unrealistic?

If the insurance company doesn't have what they need, ask your surgeon's office to send it again.  Maybe it got lost or something.

If it is covered with pre-authorization, that means that if you submit the documentation they need (they should tell you what that is, it should include stuff like past medical records that show a history of obesity, the report from your psych eval, etc), then they will send you a letter saying the surgery has been pre-authorized.  then you can have surgery and they will pay for it.  You will still have to pay any co-pays or deductibles, though. 

You can speed things along by finding out exactly what the insurance company needs, then asking the surgeon's office to send it to them.  If they say they already sent it, ask them to send it again since the insurance company says \they don't have it.

Thanks! the surgeons office keeps telling me to wait till they call me. I just don't trust either of them to get this in time I really want this!

I started my journey in June of last year, I was finally able to get my surgery last week. Hang in there, I know the waiting is bad no matter how long you have worked towards this. If the insurance company hasn't got your paperwork by now have the Dr resend them, sometimes they get misplaced or put into the wrong account.

Its only been a week since the doctors office submitted it. It can take that long for the insurance company to receive it and make it available for review in their system. I would keep calling the insurance company every day to check the status. You have the answer to the biggest hurdle and that is your insurance will cover the surgery if you meet their qualifications. When you call the insurance ask what the qualifications are for pre-approval. They should give you BMI limits, dietician requirements, and other testing they need. Your doctor likely has this information and you have already met the requirements otherwise they probably wouldn't have submitted it.  Its good information for you to have, you may need to self advocate during this.  Can you contact the doctors office and get on their surgery schedule now? I was scheduled for surgery long before I got my authorization from insurance. I got the authorization on Tuesday 5pm and my surgery was Thursday at 7 am.  Because the doctors office had already scheduled a date the insurance company had to give a quick answer. Luckily it was yes.

Just keep calling and don't take no from either the doctors office or the insurance company.

 

Keep on the doctor's office and the insurance.  If the office keeps telling you to wait till they call you ask to speak to someone else.  Explain what the insurance is telling you.  Kinda sounds like someone at the doctor's office isnt doing their job to me. :( Keep us updated. 

 

Got a call from the surgeons office it went to the wrong dept. Dr office seems aggravated that I had called and checked myself. 

Thanks for the advice. I will continue to follow up and follow up some more!

Always remember, you are the customer and they work for YOU. It is their job and the Dr. gets paid very well. I get everything by email and in writting. I too have had trouble with the right hand knowing what the left is doing. We are our own advocate and it is perfectly ok to call them. If you get attitude, talk to office manager or MD. You are worth it !!