Surgery tomorrow & Insurance hasn't said yes!

Hello Ladies:

I can't tell you how frustrated I am today. I found out yesterday that the insurance company is balking about the surgery and wants more information from the doctor. They've already sent what they have so I'm skeptical about approval. I've been with this Dr for four years - he's the one that did my ablation but I'm concerned because he doesn't order blood tests as a part of my annual so my record there doesn't show anemia. My family doctors records show the anemia and the fact that I had to go have IV Iron to replenish the stores but it's not part of the gyno's records. (That's another thing, how many of you have experience with this -- does your doctor do a blood test every year?)

I am hoping that my previous gyno (in a different city) will be able to send my records but I just found out that due to health concerns of her own she is no longer practicing. I was able to find out which doctor in the practice has her patient records but mine are right on the edge of whether they'll have disposed of them or not? AHHH!

My fear is that without the information from that file I won't be approved for surgery unless I go back to the beginning with the "take the Naproxcin (sp?), we'll do a d&c, we'll do a hysteroscopy, you're just getting older". I want to cry and nobody seems to get how disturbed I am about the whole thing.

I wanted todays post to be about all the things I'll be happy to let go of and the ones that I'll be pleased to be embracing. Now I'm in limbo!

Thanks for letting me vent!

Ana,

That is the worst. I feel so bad for you. Let your doctor work it. He can get records from your pcm. It sounds like you trust him or you wouldn't be with him for so long. Things can change in an instant.

Did you see the thread talking about the Hill Burton? It pays for proceedures at hospitals but they don't tell you it exsist?

Keep us posted today. You will be in my prayers.



k9

I am so sorry. I am to have surgery tomorrow also, and as I posted a bit ago, went through rounds of phone calls with the insurance company, doctors offfice, and hospital about an hour ago. Mine finally got settled and everyone is relieved especially me.

This is so stressful already with out insurance worries as well. I hope all works out for you tomorrow.

I understand your frustration. This is not what you should have to deal with the day before. You should be able to concentrate on getting into the right mindspace to make yourself healthy and well.

You might want to call your HR department or whomever you get your insurance though and see if they can also put pressure on the insurance company. Sometimes, I've found, that involving the folks that actually pay for the insurance (and have the ability to take their whole company's business elsewhere) can get better results than us little folks.

I know my insurance company only approved a one day stay for my abdominal procedure! And I didn't find this out until I was checking into the hospital 90 minutes before my surgery! Needless to say, my DSO had to hop on the phone right away to correct that. Not what he wanted to do while waiting for me to get into recovery (and it certainly didn't put my mind at ease!). The good news is that we did get it resolved that day (or so I hope, I still haven't gotten all the final billing stuff).

Take care!

Insurance companies are the pits i had trouble getting my hyst approved and had to cancel and reschedule my surg.

one key thing that i found out was that for my insurance a hyst is only approved for less than 24 hours of hospital stay. (this is not acceptable with my doc especially since i live 1 1/2 hours away from the hospital) so he said he would call once i was out of surg and get an auth to stay longer. (i was nautus (sp) ) anyways i get the bill for the hospital stay and i have a 10% penalty on top of my 20% co pay. they said it was cause for the type of auth given i needed to be approved 3 days ahead of time.

Funny huh how do you know if you will have complications after surg until after surg? so i am not working with the hospital to get them not to charge me or work with the insurance company (only for the 10% i will pay the 20%)

just a little info you might want to look into. good luck i know it is a pain in the a##.