Insurance Completely Denied Surgery--Dr got it Approved! | HysterSisters
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Insurance Completely Denied Surgery--Dr got it Approved! Insurance Completely Denied Surgery--Dr got it Approved!

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Unread 01-09-2006, 11:04 AM
Insurance Completely Denied Surgery--Dr got it Approved!

Ok, so now i am so badly depressed!!Im not quite sure what to think now. I was so looking forward to feeling so much better after recovery. All i hear out of womens mouth's "they wished they would have done it so much sooner than when they did". My insurance totally refuses to pay for the surgery no matter what. I guess if he gets in there and sees that i need it, i will have to go back in after the insurance company reviews the findings and THEY decide i need it. She said something about doing a D&C but i dont need a D&C. Im not sure how it got thrown in but i remember the nurse telling the insurance lady on the phone that i was having heavy periods and they were lasting long amounts of time. Well, i told her that they lasted 2 or 3 days with 1 day being really heavy. So i told her i didnt no how how it got thrown in that i had really long and heavy periods because i dont , so why would i need a D&C? So i guess the plan is to go in with the scope to look around. She kept talking and i was like OK shut up so i can get off the phone and cry like a freakin' baby. Its ridiculous, the Dr. says that i need to have this done.. Now im not even quite sure i want to go thru with the laparascope..I have went for years with no one listening to me telling me its all in my head. This is my last resort, what if they dont find anything? I guess i need to quit even thinking about it, because we wont no til after he looks around. But now im just scared because im afraid he wont find anything and THEN i will just keep going wondering why i am having all this pain?? Anyhow, i really just want to go sleep now UGH.
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Unread 01-09-2006, 11:10 AM
Insurance Completely Denied Surgery--Dr got it Approved!

You poor thing!!!!!! Insurance can really be a pain!!!! Well, hopefully he will find what he needs to prove that you need it, and it will all work out!!!! I will say my prayers for you!!!!!
Unread 01-09-2006, 11:23 AM

Sorry this is happening to you and I hope it all works out. But ya know I haven't even thought about my insurance not covering it. Do the docs pre-approval your surgery from the insurance before hand and do they only cover it for certain things? I was told my surgeon was going to look at my appendix while she's in there and possibly take it out, should it be pre-approved through insurance?
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Unread 01-09-2006, 11:52 AM
Insurance Completely Denied Surgery--Dr got it Approved!

sorry you are having problems with your insurance. If I understand you correctly you are planning to have your surgery without your insurance approval? That is a BAD idea. You will have a mountain of hospital bills and your insrance co. will not pay them. Your situation is not uncommon. Most insurance companies will only pay for a hyster as a last resort. Uness you have exhausted your other options, ie...D&C, laproscopy, they will not pay for a hyster. I would agree to the D&C and let them absorb the costs if that is what it takes to get your insurance to agree to pay. Good Luck to you! s
Unread 01-09-2006, 12:08 PM
Insurance Completely Denied Surgery--Dr got it Approved!

Hi! I am sorry that you are upset about the last minute info from your insurance company. The insurance companies often try to do what is the least envasive for patients, and cover a major surgery only when it is a last resort--this is often what a dr thinks is best as well. I had a Lap, Hysteroscopy, and D-n-C before my hyst (all at one time), and the findings from them were used to conclude that I did need a hyst, which was then covered by my insurance.

I agree with CharmedOne--I would not have the hyst if the insurance company is refusing to cover it, for two reasons. One, you may find that the D-n-C may actually help you after all, so you would be able to avoid a major surgery. Two, if there are complications from the hyst, and you are not covered by insurance, the costs could be totally astronomical. I had very good insurance with my hyst that included a cap on how much I could be charged per day while in the hospital. Even with that, due to my complications and extended hospital stay, my share of the bill was still overwhelming and due to my circumstances I had continued testing, multiple drs appts, etc., all stemming from the hyst. Had I not had insurance, we most likely would have had to file bankruptcy or ceased my medical care.

I hope you are able to find a solution for your situation. I am sending you s and best wishes during this stressful time.
Unread 01-09-2006, 04:02 PM
Now I am having a hyster...OMG!

Just wanted to give a quick update. Dr. had to get on the phone with a physician review panel. things got hairy and voices were raised...My hysterectomy is covered!OMG, i feel like i have been on quite a roller coaster since friday, having one, not having one, not sure what they will do, now back to definitely having one. OK, so anyway, now i am nervous as heck and starving to death!!LOL.. Wish me luck!!Good luck to everyone else and there big day!!!

Unread 01-09-2006, 04:03 PM
Insurance Completely Denied Surgery--Dr got it Approved!

Good luck on your surgery!
Unread 01-09-2006, 04:10 PM
Insurance Completely Denied Surgery--Dr got it Approved!

Sounds like your dr felt it was necessary and was able to get things settled! Best wishes to you!
Unread 01-09-2006, 06:35 PM
Insurance Completely Denied Surgery--Dr got it Approved!


I'm glad everything worked out with your insurance! That has to be a huge relief. Best wishes to you! I pray everything goes smoothly!

s, Deb
Unread 01-09-2006, 07:25 PM
Insurance Completely Denied Surgery--Dr got it Approved!

Good Luck Amber!

I'm glad things finally are looking up for you.


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