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Hate Insurance Companys! Updated! Hate Insurance Companys! Updated!

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  #1  
Unread 08-20-2015, 12:03 PM
Hate Insurance Companys! Updated!

I have an LAVH scheduled for Sept 4th I get a letter lastnight saying insurance is denying my claim! WHAT!! They think i have not tried enough things before having this surgery which deems it unnecessary!!

I just do not understand! Now my Dr (who told me not to worry at all) has to call them and explain further about why this is necessary. You would think, two independant Dr.'s saying i need this would be enough for them!

I dont think anyone understands my stress and frustration over this. Sorry for the post but BLAH SO FREAKING ANGRY RIGHT NOW!!

Has anyone had this happen and still was able to get their surgery on time?
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  #2  
Unread 08-20-2015, 01:48 PM
Re: Hate Insurance Companys!

I'm sorry you are dealing with this on top of facing a major surgery. I was on an HMO plan last year and had to get referrals for everything. The referral person at my PC's office was uncooperative and gave me false information. I had an EMG scheduled for shoulder pain. I was at the specialist's office for my appointment and was told I couldn't have it done because I didn't have a referral. The referral person lied and told me didn't need a referral for this. I had several other incidents like this with my PC's office. I finally had to get a new PC and I got on a PPO plan this year. It sucks to pay more out of pocket, but I like the peace of mind knowing I don't need a referral to see a specialist. From that standpoint, I can understand your frustration.

You're probably dealing with some sort of pre-authorization checklist the insurance company requires to be approved for a hysterectomy. They want you to try the least invasive methods possible first. I told my GYN I wanted a hysterectomy, but she said there were certain steps I had to follow. I had to get a diagnostic pelvic laporoscopy, D&C, and hysteroscopy. I don't think having a surgery prior to another surgery is fair, but it's what the insurance company wants. At least it did formally diagnose my Endometriosis and show how severe it is. They also want you to try birth control (I've been on various ones for 16 years without success). After that I tried Depo Provera, and now Lupron injections.

I'm terrified the same thing will happen to me and the insurance company won't approve a hysterectomy, especially since I am still fairly young (35). You might want to call the insurance company yourself and ask what they want you to do next and why they are trying to deny coverage. I know how frustrated you must be. I have seen other posts on here where this happens and ladies are still able to have their surgery on the scheduled date. Usually this happens because of pieces of missing information or that sort of thing. Keep us posted!



  #3  
Unread 08-20-2015, 02:32 PM
Re: Hate Insurance Companys!

I am also on PPO, and the last bout of birth control made me bleed non stop for 2 months it was horrid! I really hope they ( the Dr. and insurance) can sort this out I will know more by tomorrow AM.

The thing is this has been going on for the last 4 years, entirely to long to be feeling like i am feeling. UGH!!

I do hope you also get your surgery, without further delay and hoop jumping!

I had made arrangements with work and my kids to come home and help me out after the surgery so I am praying they don't delay this further and cause more grief for everyone!

Thanks for listening and responding just feels like no body understands how frustrating and stressful this is right now.
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  #4  
Unread 08-20-2015, 07:56 PM
Re: Hate Insurance Companys!

Hi Grams -

I am so sorry you are going through all of this. We have had other ladies on this site having to fight with insurance companies. You are not alone. I am sure it makes you want to and .

Hopefully your doctor can take the insurance company through their list and get you back on the right track.

Let us know what happens.

  #5  
Unread 08-26-2015, 12:11 PM
Re: Hate Insurance Companys!

I got the word on Monday the surgery is back on!! Now it is outpatient which is fine. I have my kids and husband scheduled to be with me so all should be well!!

I hope everyone else gets the ok from their insurance. It is just added stress to have them do this so close to the surgery UGH!

Now that its on and only in a week and couple of days i'm getting nervous again!!

I started this process about 4 years ago, now I just need it to be here already the wait is KILLING me!!
  #6  
Unread 08-26-2015, 02:01 PM
Re: Hate Insurance Companys!

Woo-hoo! I'm glad you have a date and everything worked out! I just had my second Lupron injection, so hopefully I will have my hysterectomy by the end of the year. Good luck!



  #7  
Unread 08-26-2015, 08:46 PM
Re: Hate Insurance Companys!

so sorry u are dealing with this... i had to try tons of things before i was allowed to get my hysterectomy.. ive been trying for 3yrs almost 4 to get it.. i do not have insurance though and am paying out of pocket for everything... luckily the place i go helps u set up a payment plan and also goes by income... i really hope u get it worked out and they can still do surgery asap
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