Darn Insurance why are they making me wait

My OB and I are waiting to here back from my insurance company. They are taking there own sweet time deciding weather or not to pre-approve my hysterectomy or not. Now come on I have had pain/cramping for 7 mths and bleeding for a month. I am stressing myself out here waiting. My body is wearing out I am constantly tired. It is getting to the point where I can take care of my kids.
Thanks for letting my vent I really needed that.

Terri

I am sorry you are having to deal with this. I have heard many times on this board of last-minute hassles (even denials) by insurance companies. So when I scheduled my LSH for 11/10, I called to ask my Dr's office if they had pre-approved it yet. They told me that they have a "service" do their pre-approvals, and they only do them one week before the surgery. I asked if I could do it, and they said no, the Dr.'s office had to provide the information.

This is so aggravating. People run into last-minute roadblocks because their docs don't do the pre-approval until the last minute!

Wishing you luck with your insurance co.

Cindy

I'm so sorry you're going through this.

Keep in mind that insurance companies aren't in the business of spending money -- they are in the business of SAVING it! (LOL)

I was amazed that my ins. company said I needed no pre-authorization for the hysterectomy. I could just go ahead and schedule it. The panniculectomy (sort of like a tummy tuck) on the other hand required an act of Congress (and they ended up turning that one down so I had to pay big bucks up front) to get approved. Oh, well.

what is this procedure?

I am facing a hyst...don't like my twin belly at all...

My husband says he 'loves me the way I am'

What is this procedure and ballpark, what does it cost?

I have know idea about the cost. I am going to have a SAH.

Terri

I am sorry. I need to read more about surgical approaches. I will look at them. Good luck with your procedure.

I have many years of experience as an insurance nurse (not on the insurance end very much at all). I know how to fight for payment.

If you, or anybody reading this message needs assistance, I may be able to help get claims processed/ surgeries authed.

I recently had a hysteroscopy, and needed to be in a big university hospital due to secondary medical problems. Initially, we thought we would have this huge deductible. I fought and won. I will continue to fight and win.

A phrase I have used a lot to push people who work for insurance companies is: 'Would you respond like you are if I was your mother?' I also ask for supervisors a lot. In pre-auth insurance, chances are you are not communicating with a Registered Nurse. Usually, techs triage the calls and refer to nurses.

So, I mean to help if I can. Honestly. It is enough stress to go through the testing and surgery. Having to deal with insurance issues is very stressful, and in so many cases totally unnecessary.

Yasmina

Yasmina:

Is it true that only the doc's office can get your surgery pre-auth'd? I live in fear of getting a last-minute rejection because the doc's office waits til the week before.

Also, my coverage is 80-20 with a $1000 out of pocket max. I am assuming this means I will have to pay $1000 for my surgery? Any thoughts on whether I can bargain on this or even get it waived?

Many thanks.

I feel for you. I really do. I was all scheduled for my surgery and then the ins decided to deny it so we had to cancel it. At this time we are in the appeals process trying to get it approved.

Like you, I am in alot of pain and find that many days I can barely take care of myself, much less my kids. I have told every single person I have talked to myself at the ins co that and they all say the same thing......well, if you want the surgery get it but your ins doesn't have to pay. I get so mad at them. It is not that I want this surgery but that I need it! My doctor has said it is necessary and gee whiz you would think that would be enough but I guess not.

We even have filed an appeal with the commissioner of lns for our state and are waiting to hear from them. So I am VERY serious about getting this taken care of so I can reclaim my life. I am tired of hurting and feeling bad. I want to be normal again!

Good luck and hopefully your ins will cover it. As it is right now for me I am just praying that some day soon I will get a call saying we have the ok and move ahead with the surgery. Each and every day is a struggle for me so I do know what you are feeling.

Unbelievable! Why are you having the surgery? Sounds like you have done everything but stand on your head! If you want, pm me. Maybe I can help in some way. How horrid for you.

Yasmina