totally confused!

I had finally wrapped my brain around this surgery and was at peace with my decision..then insurance sent letter saying NO GO!! they will preapprove the bladder and rectal repair ,but no hysto!!Pain and bleeding from large fibroids is not enough for them to authorize.Had already been over all options with dr. and she really felt this was my best option! Will try to fight them when she gets back from vacation next week ,I am just so tired and not sure if I am up for the fight...

Try to keep positive thoughts. It may just be that the doctor needs to send them more information or something.

My insurance company never actually refused, but they kept the decision pending for longer than normal. They needed more information from the doctor and they wanted a pregnancy test done before they would even consider it.

Someone told me that the doctors know how to get it done. So just have faith that if this is really what you need, the doctor will get the approval.

Oh, no! Now I'm totally confused! It never occured to me that my insurance might not preapprove my request for a hysterectomy. I am 47 and definitely don't need the uterus. Huge fibroids are causing excessively heavy and prolonged periods and I'm anemic. I certainly hope that both of our surgeries get the "go ahead" and real soon! I wish you the best!

Hi Gnalna,

I agree with what Stitcher8 said. From being on Hyster Sisters and reading posts, it sounds like insurance companies really weigh what a Dr. puts in writing as the reason for a hyst. Gnalna...just meet with your Dr. again and resubmit a letter and keep working with insurance.

Best wishes,

Mary

Yes it is all about the wording your surgeon uses. You may need some test done also that will allow the insurance to give the ok like a hysterscopy, laproscopy or endometrial bx. Hang in there just let you surgeon know what is going on and it can be fixed.

Thanks ladies, It just felt like a kick in the gut to have somebody else decide whats best for me.I got pneumonia the week after being scheduled,and that totally freaked me out ,never had anything knock me down so fast..feeling much better this week aside from the normal cramps and pains..scheduling nurse was really suprised about denial ,but i had been there before.was scheduled for a colonoscopy because mother almost died from colon cancer 2 yrs ago..they denied that saying family history was not enough reason..crazy!! Oh well i am going to keep the faith and see how it works out..thanks again

You are right. It does feel like a kick in the gut when it feels like the insurance is trying to make the decisions in your treatment. I cried for two days when they wanted to know if I had tried any of the drug therapies for endo before deciding on the hysterectomy. But my doc has a really great nurse. And I told her that the possible side effects of the meds just scared me to death and I didn't want to do that. So she told the insurance when they called the office that we weren't going there!

So, please, as hard as it is, try not to worry about it. Your doctor knows what it best, and she'll get it approved!

I'm sure this is nothing that your doctor hasn't run into before. Think good thoughts and trust that what needs to be done will be done!

It may be that the Dr.s office sent the request in to the insurance company with the wrong coding. If they do that, claims can be denied. Once the proper code is used, the green light is given.

Check with your Dr.s office to find out why they insurance company refused and see if they can resubmit with a different code.

I'll be sending good vibes your way.

Dr. got back from vacation Monday, got a call from scheduling nurse tuesday that all was approved!!Still didnt believe it until my letter arrived today from insurance co with preapproval!! Doc is awesome, biggest problem with approval was because I wont go to the dr. until I am miserable,so no history on file with pain or problems for past 5 yrs(shame on me)!Had d&c in 88,laproscopy in 93, and so many bladder problems and tests(yuk)in between that I just quit going for my regular exams and started my pharmacy at home.lol
was waiting for natural menopause ,but no where close to that ,so very happy to hopefully be going in right direction..Now my heart is doing flip flops and i am going to go start my preop freaking out now..THanks so much for all the support!!
Gina