Tralynn222

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On 10/11/07 I receive a phone call from Loretta at Dr. Bagan's office in Pt. Charlotte, FL.  She says that the letter they recv'd from BCBS of MI states that this surgery does not require pre-authorization so that means they do not give a pre-auth number.  It is the surgeon's responsibility to make sure that the requirements are met, perform the surgery and then bill for it.

Loretta tells me that I need to call BCBS and start screaming.  When I call BCBS, i request to speak with a supervisor.  Explaining to her that my surgeon will NOT perform the surgery without pre-auth.  She says that that is on the surgeon and that if they absolutely require it then they will need to file an appeal which could take another 90 days!!!!!

When I call Loretta back at Dr. Bagan's office in Pt. Charlotte, FL - and tell her what BCBS said, she says let me talk with the head nurse (Sandy) and get back to you.

When she calls me back, she states that Sandy said that they've already spent way too much time on this and that they are washing their hands of my case!!!!  

I was in tears - literally.  

The Lord is so good though - when one door slams in your face, another one opens.

I then called the WONDERFUL people over at Bradenton Surgical Group in Bradenton, FL.  When i explained to Michelle my two year long hellish ordeal with Dr. Bagans office she says that they don't know what they're doing over there.  The pre-approval letter that I recv'd back in July was all that I needed.  She apologized immensely that I've had to go through all of this and scheduled an appt for me immediately.

I now am scheduled for Surgery on Nov. 13th, 2007 and cannot be happier.

I highly recommend finding yourself another surgeon if you're waiting for an approval at Dr. Bagan's office  You're never going to get it because they do NOT know what they're doing over there.