Upcoming hysterectomy 8/19: No relief for me

I don't even know where to start. I have had awful periods forever, with some relief after childbirth, then progressively worse. I bleed for weeks at a time and the pain can get really bad. On July 6 my gyn and I discussed a hysterectomy and scheduled it for August 19.

That began this whole nightmare that is ending in me not getting a hysterectomy. Apparently the gyn didn't submit and medical notes on July 6 then ignored the insurance companies multiple requests for records. On July 10 they denied the surgery. The dr told me the last week of July that the insurance company was requiring a biopsy and other tests (they didn't make this requirement). I did that on Aug 5 but all of this time and extra testing could've been avoided if someone had just submitted something 5 weeks ago.

My surgery is scheduled for the 19th but my insurance has until the 21st because it's been reviewed, denied, escalated, and now it's stuck in something called a "case system" to be decided by the 21st.

I talked to the drs office (my dr is out of the office until next Tuesday) and the surgery scheduler told me to call back after 2:00 yesterday but neglected to mention they closed at 2:00, so I'm stuck for the weekend.

If anyone could tell me what they think or what you would do, I'd appreciate it so much. I'm hurt and angry at my gyn who I've trusted for nearly 8 years and feeling so lost now.

My advice would be don't be afraid to see another gyn. I had been going to a particular practice for years thinking I was getting the care I needed, but a few years passed and I started having unusual pain, so my fiance convinced me to go get examined. I went with another practice because I had different insurance. This new gynecologist was amazingly thorough and discovered that I had several problems going on, culminating in the hysterectomy I'm about to have. She was not only thorough in examining me and taking the proper biopsies and scans, but she was also quick to get me into my GP for a pre-op physical and lots of blood work so that when I could finally see a surgeon and get scheduled I'd be ready, which was wonderful considering I'm starting a new job soon.

Your doctor's office screwed up pretty royally from what you described, and I would not hesitate to find someone else to work with to get your relief. Using resources like ZocDoc is a big help because you can get other people's ratings and impressions of the doctors. Also, most insurance companies have comprehensive provider directories that include a lot of detailed information about what they do.

Good luck to you, I hope you find your relief soon!

Hi Daikichi -

Were you able to contact your doctor's office?

What is your status?

I'd written a long post but it got eaten. The short of it is the dr's office blames insurance and insurance blames the dr and I'm stuck in the middle. The authorization is trapped in some department that no one can reach until the 21st.

Meanwhile, my dr was on vacation again and unreachable. I thought he might call today but I guess I'm just another number there.

	Quote:
Originally Posted by Cassiopeia1982 My advice would be don't be afraid to see another gyn. I had been going to a particular practice for years thinking I was getting the care I needed, but a few years passed and I started having unusual pain, so my fiance convinced me to go get examined. I went with another practice because I had different insurance. This new gynecologist was amazingly thorough and discovered that I had several problems going on, culminating in the hysterectomy I'm about to have. She was not only thorough in examining me and taking the proper biopsies and scans, but she was also quick to get me into my GP for a pre-op physical and lots of blood work so that when I could finally see a surgeon and get scheduled I'd be ready, which was wonderful considering I'm starting a new job soon. Your doctor's office screwed up pretty royally from what you described, and I would not hesitate to find someone else to work with to get your relief. Using resources like ZocDoc is a big help because you can get other people's ratings and impressions of the doctors. Also, most insurance companies have comprehensive provider directories that include a lot of detailed information about what they do. Good luck to you, I hope you find your relief soon!

This doctor has generally good ratings that I would've agreed with until now. He saw me in early July and has been out of town off and on, for days at a time, since. Because he's been gone so much, paperwork sat on his desk and he's been unavailable to answer questions. I had to wait from July 7 to July 24th (though he did call me from wherever he was vacationing) to answer questions I had.

But if you'd asked me in July 6, I would've shouted his praises from the rooftops.

I need to say that not every doctor who is a great clinician is also great with paperwork and especially insurance....
When the insurance asks for records and proof and the doctor is not doing it - nothing will move.

Some insurances are more picky than others but once you get reviewed it takes time and the right papers.

Because I have been with one insurance for many years they had all the claims for the different things I had tried prior to hysterectomy and how it did not work - so there was no review needed.

Sorry you are stuck with this.