sad

Unfortunately for us, insurance companies aren't in the "health" business. Their business is gambling - they gamble that they won't pay out more than they take in. One very effective way to accomplish this is to deny, as a matter of course, most claims. This works for them because a good portion of the patients will just accept the insurance company's decision and forego their (probably badly) needed treatment.

My DR recommended a hyst a year and a half ago which the ins. co denied. It took a long time, but I'm finally scheduled for surgery this Mon. Hopefully your fight won't be as long, my DR told me up front that my particular ins. co. is especially bad about authorizing hysts for women in their early 40's.

Just stay vigilant, they'll have to come through for you. Good luck, and hang in there!

Thanks Caribbeanblue. You have been so helpful to me. I emailed the Missouri Department of Insurance. I plan to call them tomorrow, as well.
Like I said in one of my previous posts, I am not an overbearing person at all, but this is something I believe in and I definitely believe in a better quality of life. My mother died 20 years ago to the day that I found out I was denied approval of surgery. She was a smoker and died of lung cancer at the age of 52. One of the reasons I chose YES when the doctor mentioned surgery is I know my kids are tired of mom (me) laying around after school with her heating pad and taking pain meds all the time. (This reminded me of my mom being sick often when I was younger.) I want to enjoy my life........live it to the fullest...let my kids enjoy being with mw...is that too much to ask?
WHEW!!!!!!!! This was suppose to be a thank you to Caribbeanblue and everyone else (JUICE) who has talked me through this................you have helped a lot.
THANKS.....

You are very welcome Itsie. Hopefully the MO Dept of Insurance can at least help you speed up this process so you can be healed by the end of your summer break! After my insurance company got the complaint, I was told they had 21 days by law to respond but since they put an URGENT on it, they were left with only 24 hours to make their decision.
Once they see you are not going to back down without a fight, I think they are going to change their tune. Too bad they play this insurance game with us and waste our valuable time.
When they agree to certify, make sure you talk to your doctor about getting in as soon as possible. I had told my doc that I was tired of the pain and couldn't take it another day. She scheduled my surgery within 2 weeks.
Best of luck to you!!

Wow...I'm scheduled July 15th for LAVH...never crossed my mind that my insurance company could deny it! Do these insurance companies realize the mental anguish we are already in over these surgeries! The last thing we need is some shirt and tie behind a desk somewhere deciding whats to be approved and not approved..... I thought thats what our doctors spent years in school for was deciding whats best for their patients in these situations. I hope I do not run into that but I guarantee if I do I'll fight with everything I have....right is right... we are not having a face lift or tummy tuck here. Insurance companies make me sick....I did not wake up one morning look in the mirror and just say hey I have nothing to do with my life this month lets take out my uterus...AAAaargh! We have enough concerns without our insurance companies being one of them!
My thoughts will be with you...hang in there... bebo11

Again, thanks to all who have answered my questions about the **** insurance companies. I have contacted a VERY NICE lady from the MO Dept. of Insurance and feel confident she can help me through this. How long it will take, I have no idea. I just want a better quality of life....is that asking too much?