Not Yet..GRRR

Well surgery should have been 9:30 this morning, as you can see I am here so that didn't happen. Dear Doc called my home at 9pm last night to tell me that he was having last minute problems with my insurance company. So much fun! Seems that I don't fit the 'criteria' for what they expect someone to be having a hysterectomy for. So the clinical nurse there said she had to get a sign off from the clinical Dr at the insurance company. That she could not authorize on her own. So my doc spent all day arguing with her yesterday and was told that they have 48 hrs to review my case before authorizing. So my Doc asked could they not leave the golf course for 10 minutes to sign a paper? Lol!!! Go Doc!! Well, this morning, he decided to just call back and act like this was the first time he had called. The very first person he talked to signed off on my authorization and gave him the authorization number we needed! He said that she had the same problem I had and was more understanding! I can't believe that they wanted me to have more surgeries, seems like they would want to go the cheapest route. But my coverage is up with them Jan.1st so I think they were just trying to get out of paying. My surgery is definately set for Dec.26th at 1pm now. I am already on leave at work,so I will use this week to get ready! Sorry this is so long but I had to vent!!

{{{{{{{Sherrie}}}}} I am so sorry hun that this happened to you but at least you only have another week to wait. Try and enjoy Christmas! Sometimes there is a reason why things happen the way they do. At least now you can get those things done! Good luck hun!


Emily s

Thank you Emily! You guys here have been a great support system! I guess now I have time to finish getting things ready for Christmas!

Hi Midnyte_blonde.
So glad you got approved for your surgery. And tell your doc....way to go!!!! We all need drs going to bat for us like that.

My insurance co still isn't sure they're going to pay. Talked with them yesterday and they say they have my date listed but until they get the reports from the hospital, after the surgery, they won't know. Said if they consider it a pre-existing condition, then they won't pay. The insurance rep said if I'd not had any treatment for it prior, then they should pay. "Should" being the key word here. But we switched insurance companies in May because we wanted one with better rates and coverage. So who knows what they'll do. They make sure you're not late with that monthly payment though....and being self-employed, it's a bunch.

So dh was going to contact the rep again and try to get some kind of answer.

Hope your holidays are wonderful and best wishes and prayers for a successful surgery and a speedy recovery.

Sparklies, you might call your state Insurance Commissioner's office; the rules about pre-existing conditions vary, and sounds like the insurance company is playing games. Get the straight scoop about what the law requires, and consider an appeal of the "non-decision". There are legally mandated time frames for dealing with some of these issues, so take advantage of them.

Good luck!

Sparkles- That is the exact reason I almost had a heart attack when my doc called and said that there was a delay!~ With me switching insurance Jan. 1st, he said if we didn't get the surgery in before then or if I opted to have any of the other surgeries they were suggesting, the new insurancxe would call it pre-existing!