Not So Wonderful Surprise!!

I got a letter today from my company telling me they were switching to a new insurance company effective 12/31. This is not good as my surgery is scheduled for Jan 4th already have pre certification and everything with the old company. I called our HR person and she assures me that the new company will cover my surgery but I am still not comfortable with that. She tells me to file it all with my old company and they will reject it but by that time we will have all the numbers to be able to file with the new one. Now the new one requires pre-certification too so I am very nervous they won't pay also they could call this a pre existing condition and not pay. I would call my dr to see if he could move it up but I know they gave me the earliest available time to begin with and I'm afraid if I mention there is a problem with insurance he will refuse to do the surgery. This is just what I needed on top of everything else. Sorry just needed to vent.

Debbie, I work for an insurance company and the necessary approval can be done ahead of time with assistance from your human resources and the customer service line. If they won't cooperate, notify the hospital and the physician of your new insurance information during the week between Christmas and New Years and on 1/2/01 they should be able to do all the necessary calls and fax any letters necessary. You can't wait any longer and you may need to raise your voice with a few people but it IS possible. Good Luck !! Val

I went through a similar situation. My medical group went bankrupt and shut down the day before my first surgery, but let me know about a week later - so I had the surgery, but wasn't really covered. What a mess. I was able to transfer to a new group within the same ins. co.. Everything turned out fine, but I didn't get final approval until just a few days before my surgery. Keep after them - do everything they ask, supply all the info they need, and don't assume they'll just take care of it. I got wonderful, helpful reassurance that everything was handled several times, but it didn't get handled. Stay in touch with your doctor's office to see if they need you to do anything (change primary care provider, send in info, etc.). Stay positive. Keep using lines like "My surgery is on Jan. 4th. What do you need from me so coverage is in place by then?" Don't waver on the date - make 'em stick to it. Several times it got to looking pretty hopeless, but we pulled it off. My doctor's office was a great advocate, and worked really hard to get the ins. co. to do their job. I'm sure you can work through this, just stay really on top of everyone.

Good luck! The only thing worse than waiting is messing with insurance companies.