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Med. Ins. & Doctor's Orders???!!!  Help... Med. Ins. & Doctor's Orders???!!! Help...

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  #1  
Unread 03-06-2002, 08:20 PM
Med. Ins. & Doctor's Orders???!!! Help...

Hi everyone,

12 1/2 days and counting...I am trying so hard to keep myself busy. Lately I have been so tired during the day that I need to nap for about 3-4 hours. Has anyone else felt this way?

Anyway, today I drag myself to the mailbox and I get a letter of authorization from my insurance company. They approved the operation -- but it says SUPRACERVICAL HYSTERECTOMY.

My pre-op appointment papers say TAH/BSO. I asked my doctor if this means everything (cervix, etc.) and he said yes. From what I read about the Supracervical Hysterectomy it says they leave the cervix intact.

Now I am confused. I know what my doctor and I want. We have discussed this in detail and thoroughly.

Should I call the insurance company? When I called them yesterday regarding something else, they did inform me that my GYN's office called in to get approval which obviously they got. Maybe someone at my dr.'s office got it wrong. I don't know.

I don't want to wind up having to pay the difference because of a clerical error.

What should I do? So my heart is beating 95 miles an hour.

Also, the insurance company gave authorization for 2 days stay in the hospital. My doctor and I discussed 5 days.

I want to call them just to say, "Hey, why not take me through the drive through, get it done along with a buff and wax and send me on my way." This is nuts.....

My H and I pay for this insurance privately and it's almost as much as a mortgage.

Any ideas? I don't want to lose my temper, but between waiting and now a different operation approved, I am confused and upset. Can't sleep as it is.

Oh, when it rains, it pours...please let me know what you all are thinking....

And...thanks. All my sisters' advice or just talk means so much to me.

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  #2  
Unread 03-06-2002, 08:36 PM
Med. Ins. & Doctor's Orders???!!! Help...

Hi! Fortunately you still have plenty of time to get this glitch taken care of. Why don't you call your doctor tomorrow and tell him what happened, and see if he says he will have his office straighten it out? Then wait a day, and call the insurance co. and make sure it happened. You are right, you don't want to end up paying for something because the pre authorization was wrong.

I understand about paying for your own health insurance. I am doing the same. The problem is my DR (who is a saint in my eyes, even after the surgery!) isn't a PPO. I was terrified of this. The bills from my surgery have been rolling in. The hospital was almost $15k but they are a PPO so I only have to pay about $800 of it. Same deal with the anesthesiologist - out of about $3500 I have to pay a few hundred. My DR's bill was $5200 for the combined surgery. I received it the other day. Today I got another copy of it, on which there was a hand written note saying that she had found out that my insurance company wouldn't pay her bill so she decided to discount it 50%, and here was the revised bill. I almost fainted with relief. There are some good ones out there!

So, don't worry yet, give everybody the benefit of the doubt because there's time, and just calmly plug away at getting it corrected. I know this is a very stressful time for you, but I bet if you assume it was just a clerical error and the doctor's office will want to correct it, they will. Please let us know what happens, and good luck with your surgery.

s,
- Linda
  #3  
Unread 03-06-2002, 08:40 PM
Hey

I am not an expert by any means but does the DR charge for how much he takes out? I didn't know that. Anyway my DR wasn't sure if she would take the ovaries and after going in she did, so I am not sure if it was on the insurance papers or not. I would call the DR office and ask to talk to the person who does the insurance paper work. And it is soooo normal to be nervous. Just hang in there it will be here soon. God bless.
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  #4  
Unread 03-06-2002, 08:54 PM
Med. Ins. & Doctor's Orders???!!! Help...

Hi Frances, maybe it varies with the doctor but the bill I received had the amounts for the TVH, BSO and A&P repair listed separately. Incidentally the A&P repair was the most expensive part.
- Linda
  #5  
Unread 03-07-2002, 07:19 AM
Straightened out Insurance Glitch

Hello sisters,

This morning I called the dr.'s office and spoke to a sweet woman who explained to me that this was an error and would be a mess after the surgery was performed.

She told me that when they called it in to the ins. co. someone (dr. office or ins. co.) put the wrong procedure code in.

So....she called me back and said they corrected the problem on both ends and that the ins. co. will be sending me the correct authorization by mail.

The doctor's office thanked me for noticing and correcting this error.

Well anyhow, 11 days to go and counting. It's important to check all paperwork; just in case.

Thanks for all who answered.

  #6  
Unread 03-07-2002, 10:08 AM
Med. Ins. & Doctor's Orders???!!! Help...

My castle date is on Monday. The are there in full force.
When the hospital called last week and preadmitted me they informed me that all the insurance approvals were there already. What a relief. My Dr office just called me to review the prep and also informed me that all was there and in order.

Bring it on I'm ready to get it over with!
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