HysterSisters.com is a massive online community with over 475,000 members and over 5 million posts.
Our community is filled with women who have been through the
Hysterectomy experience providing both advice and support from our active members and moderators.
HysterSisters.com is located at 111 Peter St, Toronto, Canada, M5V2H1 and is part of the VerticalScope network of websites.
With free registration, you can ask and answer questions in our HYSTERECTOMY forum community, get our FREE BOOKLET, access Hysterectomy Checkpoints and more.
You are not alone. The HysterSisters are here for you. Join us today!
|
|
Real stressed now and in need of insight!
|
05-31-2002, 06:36 PM
|
HysterSister
|
|
Posts: 494
Hysterectomy: June 17th, 2002
Surgery Type: TAH
Ovaries: Removed both
|
|
Real stressed now and in need of insight!
Hello hello and hello! No I am really stressed out ladies and I don't know what to do! My HMO denied auth. of my TAH/BSO! I don't have much experience with HMO's anyone know what to do from here! Any advice would be appreciated! Thanks
|
Sponsored Links
|
Advertisement
|
|
|
05-31-2002, 06:42 PM
|
Guest
|
|
Posts: 323
Hysterectomy: June 10th, 2002
|
|
Your doc should go to bat for you!!
Sharon,
I didn't have to deal with an HMO, but when I asked my doc what I needed to do to get my surgery approved, he said to leave that to Donna, his nurse. He said that it was her job to get it approved and to send the insurance company all the necessary info that they would need.
I would discuss this with your doc. He's the one that knows all the right technical terms to use that the insurance company is looking for. You may want to call your insurance company to see why it was denied, and then take that info to your doc so that he knows how to respond to them!
'S!!!
I'll be praying for you sweetie!!!
|
|
05-31-2002, 07:24 PM
|
Guest
|
|
Posts: 49
Hysterectomy: June 19th, 2002
|
|
Real stressed now and in need of insight!
oh my!
I am with am HMO and I didn't have any problems, didn't know it could be turned down tho either...what HMO? email me if you want.
|
Sponsored Links
|
Advertisement
|
|
|
05-31-2002, 07:30 PM
|
Guest
|
|
Posts: 104
Hysterectomy: May 16th, 2002
Surgery Type: TAH
Ovaries: Removed both
|
|
OH MY
Sorry...I have no experience with an HMO but can't imagine the frustration Will be your dr will get it straightened out for you. Try not to worry ( ) right!?
|
|
05-31-2002, 08:28 PM
|
|
HysterSister
|
|
Posts: 3,099
Hysterectomy: March 5th, 2001
Surgery Type: TAH
Ovaries: Removed both
|
|
Real stressed now and in need of insight!
I agree...talk to your doctor right away and let him/her do battle for you. It's not up to some bureaucrat at an HMO to determine what medical treatment is appropriate for you.
Let the doctor's office handle it...I'm sure that this is something they have encountered before and they'll know how to deal with it.
I'm sorry you have to go through this frustration! Please let us know what happens.
s
Karen
|
|
05-31-2002, 09:48 PM
|
|
HysterSister
|
|
Posts: 3,030
Hysterectomy: May 9th, 2002
Surgery Type: TAH
Ovaries: Removed both
|
|
Real stressed now and in need of insight!
(((((Sharon)))))
Aw sweetie, I'm sorry!! HMO's can be a BIG pain in the butt to say the least!!!! s
I've been doing medical billing for over 15 years now, so one thing you might want to do is call your HMO personally. A lot of surgeries have certain criteria that needs to be met before they will approve a procedure.
For example: The HMO might require a certain amount of time trying alternatives that your GYN might not feel is in your best interest. All it would take to correct a problem like that is for the GYN to write a letter to be faxed over to the appeals department of your HMO.
I would suggest your best plan of attack would be to get on the phone with the HMO first thing Monday morning...find out what the denial is for (and make sure you get the name of the person you talk to there!!! VERY important!!) and then call the GYN's office and ask to speak with the nurse that works directly with the GYN (make an appt if necessary)
To many times the insurance companies tend to forget that there are humans attached to those referals! :burning:
Another piece of advice....if you are NOT satisfied with the rep that you are dealing with, you have the right to request another rep or better yet, the supervisor! Some of the CSR, I'd just like to *punch* for all the aggrivation they have caused my patients !
Good luck sweetie! I'll be sending your positive thoughts and Hugs!!
Love & Hugs
|
|
06-01-2002, 06:39 AM
|
Guest
|
|
Posts: 121
Hysterectomy: June 4th, 2002
|
|
Real stressed now and in need of insight!
Now this is something I know way too much about. I was originally scheduled to have TAH on May 7th. Insurance company denied because my doctor actually listed other options we had discussed. They denied me becuase I didn't try the BCP. Except one peice of info was left out. I can't take BCP. Someone on the board advised me to make the referral girl at GYN's office my best friend since she was the one who had to fight for me. I did, she did and I'm going to the castle on June 4.
I would also suggest trying to get to a supervisor at the Ins co and deal with only the same person. I was told different things by just about everyone I talked to. Once I dealt with only one person, she knew what was going on and we made some progress.
Good luck!
|
|
Similar Threads
|
From This Forum |
From Other Forums |
7 Replies, Last Reply 06-19-2008, Started By Sue1 3 Replies, Last Reply 07-02-2005, Started By bluefrogul 8 Replies, Last Reply 12-25-2004, Started By bb152 8 Replies, Last Reply 08-01-2004, Started By gracie923 8 Replies, Last Reply 11-02-2003, Started By divagoddess_38 1 Reply, Last Reply 05-03-2003, Started By 2short 2 Replies, Last Reply 04-10-2003, Started By savedbydbelle 2 Replies, Last Reply 10-06-2002, Started By jeaniebeanie 8 Replies, Last Reply 08-16-2002, Started By NickyNina 6 Replies, Last Reply 02-11-2002, Started By Shirl0 |
9 Replies, Hysterectomy Options and Alternatives 1 Reply, Natural Meno Post Hysterectomy - Kept Ovaries 2 Replies, Cancer Concerns - GYN 2 Replies, No Uterus - No Ovaries - No Hormones - Managing Menopause 3 Replies, Hysterectomy Options and Alternatives 7 Replies, Hysterectomy Recovery (post hysterectomy) 2 Replies, No Uterus - No Ovaries - Yes HRT - Surgical Menopause 2 Replies, Hysterectomy Recovery (post hysterectomy) 4 Replies, No Uterus - No Ovaries - Yes HRT - Surgical Menopause 2 Replies, No Uterus - No Ovaries - Yes HRT - Surgical Menopause |
|
Advertisement
Hysterectomy News
TODAY'S EVENTS
Calendar -
Hysterectomies -
Birthdays
Request Information
I am a HysterSister
Your Hysterectomy Date
$vbulletin->featuredvideos is not an array!
Advertisement
Advertisement
|