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UPDATE: Grrr...feeling so misled!
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11-07-2005, 02:52 PM
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Guest
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Posts: 60
Hysterectomy: November 16th, 2005
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
Here's a link to the original thread:
https://www.hystersisters.com/vb2/sho...t=Amethyst1967
Fabulous news!!!
Today was the day for the telephone appeal my dr. scheduled with the ins. co. after they denied my pre-cert.
Dr. called the ins. co. several times and was told that someone would call him when they were available. As instructed by his scheduler, if I didn't hear from the office by 2pm to give them a call. As it turns out, the ins. co. wasn't returning his calls. I said that I'd see what I could do since I was the insured pt. I was on hold for 45 minutes (guess they thought I'd give up after awhile!) and made it clear to the person at the ins. co. that the dr. had left several messages and had instructed his staff to pull him from a room the moment that the ins. co. returned his call. Finally I was told that the med. director would personally give my dr. a call by the end of the day (4:30pm EST).
Ten minutes later I received a phone call from the dr.'s office...the med. director apparently called my dr. while I was on hold and after speaking with my dr. he authorized my pre-cert.
I'll be having my SAH on 11/16! Woo hoo!!!
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11-07-2005, 03:03 PM
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HysterSister
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Posts: 1,695
Hysterectomy: April 1st, 2005
Surgery Type: TAH
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
I am so happy that everything worked out for you!!! Insurance companies can really be a pain in the butt and add extra un-needed stress before a surgery.
Good luck to you!!
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11-07-2005, 03:17 PM
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Guest
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Posts: 11
Hysterectomy: August 10th, 2005
Surgery Type: TAH
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
I am so glad your insurance co finally got on the ball. As a medical biller, I can tell you that the misinformation may very well have been on the insurance side. I can't tell you how many times I've made several calls on the same account to the insurance only to be told upon followup that they can't find any record of my calls. I even had one that told me that they couldn't find a claim on file, when they had already paid a portion of what they were supposed to! Good luck, girl, and keep your chin up. Mental attitude is half the obstacle in this thing. I'm coming up on 12 weeks postop and can't believe how much better I feel. Glad this is one thing off your plate. Best wishes.
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11-07-2005, 03:32 PM
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Guest
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Posts: 60
Hysterectomy: November 16th, 2005
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
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Quote: |
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Originally Posted by tanner413
I am so happy that everything worked out for you!!! Insurance companies can really be a pain in the butt and add extra un-needed stress before a surgery.
Good luck to you!!
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Thanks for the well-wishes...I'm actually looking FORWARD to 11/16!!!
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11-07-2005, 03:45 PM
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Guest
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Posts: 18
Hysterectomy: November 15th, 2005
Surgery Type: SAH
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
I agree. working for a major insurance carrier, our general precert dept has certain "rules" they must follow. After that, it requires a medical director to get anything done. And i've seen claims that I have personally submitted to our medical director for review take MONTHS!! I will send weekly follow up for an answer (and I'm talking internal mail) and I wait forever. The majority of insurance companies are self insured (unless it is an HMO) and then the insurance commissioner has VERY little they can really do to assist you. I'm very glad you got it all worked out. I must agree. ALL calls are automatically logged in when it rings through our system, but some "disappear". I've faxxed claims where they paid on pages 1-9, and 12-15, but they have no record of pages 10-11?? HOW??
Anyway. I'm very happy for you!!
M
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11-07-2005, 03:46 PM
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Guest
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Posts: 60
Hysterectomy: November 16th, 2005
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
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Quote: |
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Originally Posted by Ferriswheel
I am so glad your insurance co finally got on the ball. As a medical biller, I can tell you that the misinformation may very well have been on the insurance side. I can't tell you how many times I've made several calls on the same account to the insurance only to be told upon followup that they can't find any record of my calls. I even had one that told me that they couldn't find a claim on file, when they had already paid a portion of what they were supposed to! Good luck, girl, and keep your chin up. Mental attitude is half the obstacle in this thing. I'm coming up on 12 weeks postop and can't believe how much better I feel. Glad this is one thing off your plate. Best wishes.
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Thanks for the well-wishes...I'm hoping that I'll feel much better after I've fully recuperated!
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11-07-2005, 05:12 PM
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HysterSister
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Posts: 390
Hysterectomy: September 26th, 2005
Surgery Type: TAH/SAH
Ovaries: Removed both
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UPDATE: Grrr...feeling so misled!
I am happy that your insurance situation got all worked out.
s
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11-07-2005, 05:43 PM
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Guest
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Posts: 28
Hysterectomy: December 27th, 2005
Surgery Type: TVH
Ovaries: Kept 1 or both
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UPDATE: Grrr...feeling so misled!
Hoping my issue with insurance can be solved just as quickly for my TVH on 11/15.
Congrats!
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