ANTHEM

Anthem has a great process that started this year.  I had so many problems with my doc's office sending in partial information.  At first no Upper GI, the doc's office said I thought you had that...I hadn't, then a letter of medical necessity from my PCP, she did not know I needed that.  I said I will get one from my orthopedic doc (because of knee trouble) she tried to tell me she did not need that but I sent it anyway.  I ended up faxing the last bits of information directly to the case manager at Anthem.  She was fantastic and said"I know how important this is for you so I will call you when I review it and call you back...and she did and told me she was mailing out the letter that day. 

The chick at my Dr. Office cost me $2000.00, I started the process in August of last year and I met my stop loss and my plan was paying at 100%, Dr Huse said he could get me in by the end of the year.   A co-worker went through the same process Dr and Anthem and this same office worker got everything she needed including a Dec. surgery date.  She did not start the process until the end of October.

Now I have to pay the 20% co-pay which will be approx. $2000.  Darn, I could have gotten a start on a great wardrobe.

Hang in there, Anthem will work with you.  It is so important the doctor;s office send what is needed the first time.  A check off list would be a great idea in my case.

Lisa

SAD thing this whole time, while waiting, is i am eating more due to nerves! hopefully this will get solved today (Wednesday)! I was thinking last night, wonder if they do this to test us????

Did you find out anything yesterday?  Hopefully you got some good news.  Did you go to the support group last night?  My wife and I did go.  It was pretty good.  We got some good advice. 

One woman that was there found out yesterday that her A1C level was too high and that her surgery would have to be postponed.  She was due to have surgery on the 13th.  She had her blood redrawn yesterday.  Maybe it was just a fluke and her surgery will go as scheduled.

No didnt hear a word only that they got the information this time. I have come down with a nasty cold due to great niece 1 year old kissing and hugging Sunday and she was blowing nose bubbles i found out later. Felt lousy and wouldnt have been much of a listener. Hoping the best for you guys on your upcoming dates here. Will be here soon for you. Keep me posted. Will try to get to the May 13th meeting.