Ranting about insurance companies
Post Date: 7/18/08 11:56 am
I recieved a phone call from my hospital case person Brian at GWU about my paperwork. He told me he called the insurance company and that they wouldn't accept my 3 months of weigh****chers just my visits to the nut. I am going to do 6 months with the nut anyway, but it's just the way insurance companies do things and I had already spent that money on 3 months of weigh****chers. First off I called the ins. co. 6 times no not once but 6 and talked to 6 different people in the beginning to make sure they excepted weigh****chers and all of them said yes they did, so I made sure that I would have all of my ducks in a row and I did a pretty good job of it when I went to see my surgeon with me having a folder with my psych exam, my nut visits, my weigh****chers visits, a letter from my PCP, bloodwork and everything else I had to boot. So today when I called the insurance company I gave the guy on the other end an earful telling him that I was lied to 6 times and now he is telling me that weigh****chers is not excepted either. So as I proceded to yell at him and then in one sentence I told him I wanted to speak to a supervisor. He told me she was busy and that she would call me back in 2 hours or less he promised. Well I recieved a call back in about 15 minutes. I wanted to yell at her too but she was just to polite answering all my questions and I also gave her the procedure number for the sleeve and she said that she would give me a call back to see if they excepted that surgery and that of the guy that I talked to early in the morning she would straighten him out on benefits. Well she called me back after about 20 minutes and told me that the code for the sleeve is excepted surgery but I had to get it pre approved which I knew that anyway, and she documented everything she talked to me about in my file including excepting the sleeve operation. My thing is why don't these damn insurance companies make it easier on everybody and just approve the damn operation for all who has the proper BMI with no questions asked, but they would rather spend more money on paying for co-morbidities that you go in for which I don't have any except for sore knees and ankle from my weight. Sorry everybody but I had to vent. I did the raising hell on the phone in hopes somebody else doesn't have to go through it. Damn it MD-IPA cowboy the _ _ck up.......
I recieved a phone call from my hospital case person Brian at GWU about my paperwork. He told me he called the insurance company and that they wouldn't accept my 3 months of weigh****chers just my visits to the nut. I am going to do 6 months with the nut anyway, but it's just the way insurance companies do things and I had already spent that money on 3 months of weigh****chers. First off I called the ins. co. 6 times no not once but 6 and talked to 6 different people in the beginning to make sure they excepted weigh****chers and all of them said yes they did, so I made sure that I would have all of my ducks in a row and I did a pretty good job of it when I went to see my surgeon with me having a folder with my psych exam, my nut visits, my weigh****chers visits, a letter from my PCP, bloodwork and everything else I had to boot. So today when I called the insurance company I gave the guy on the other end an earful telling him that I was lied to 6 times and now he is telling me that weigh****chers is not excepted either. So as I proceded to yell at him and then in one sentence I told him I wanted to speak to a supervisor. He told me she was busy and that she would call me back in 2 hours or less he promised. Well I recieved a call back in about 15 minutes. I wanted to yell at her too but she was just to polite answering all my questions and I also gave her the procedure number for the sleeve and she said that she would give me a call back to see if they excepted that surgery and that of the guy that I talked to early in the morning she would straighten him out on benefits. Well she called me back after about 20 minutes and told me that the code for the sleeve is excepted surgery but I had to get it pre approved which I knew that anyway, and she documented everything she talked to me about in my file including excepting the sleeve operation. My thing is why don't these damn insurance companies make it easier on everybody and just approve the damn operation for all who has the proper BMI with no questions asked, but they would rather spend more money on paying for co-morbidities that you go in for which I don't have any except for sore knees and ankle from my weight. Sorry everybody but I had to vent. I did the raising hell on the phone in hopes somebody else doesn't have to go through it. Damn it MD-IPA cowboy the _ _ck up.......
Dusty Cassidy " It's not a real adventure unless you come home with a scar "
Current weight 219.0 Lbs My Ideal weight 188 I love my sleeve
Current weight 219.0 Lbs My Ideal weight 188 I love my sleeve
Oh I know most of the insurance companies are such STICKLERS!!!! They want you to have time to change your mind. And they should take the 3 months of weigh****chers are part of the 6 months. That is so not right! Im sorry you have to endure all of that but it will fly by and your surgery date will be here before ya know it. 
Best of luck to you!!!!! ~Jilly~
Best of luck to you!!!!! ~Jilly~ 
(deactivated member)
on 7/18/08 9:08 am - Millersville, MD
on 7/18/08 9:08 am - Millersville, MD
when i started down this path a couple years ago, MDIPA was affectionately referred to in WLS forums as MDI Don't Pay! Nope, they wouldn't pay for WLS at all! so, i immediately switched to aetna, based on advice i believe i read HERE. i'm not, by any means, singing aetna's praises. afterall, they are all over the news today for cancelling the insurance of a brain surgery patient in florida that may die without the surgery (state of FL intervened and they have agreed to pay for the procedure). however, i did have a pretty smooth sail through the red tape in the past few months. i am grateful after reading what some people have sadly had to go through! just keep documenting everything. it will all work out in the end!
I'm feeling all of your anger and frustration! I really hate when people just don't do their jobs right, give miss information, and lead you down the wrong road. I'm trying to eliminate that and if I have to do a supervised diet, I want to start it with the right supervisor. I'm just getting started and have already lost 5 weeks by not starting on one. Good Luck to you and keep posting your experiences, they will surely help others. Penny
You can always log (or at the very least "threaten" )a complaint with the Maryland state Insurance Commission. Maryland has current LAWS prohibiting insurance companies from changing criteria at will. I was at the point of complaining about Cigna for the same sort of things. Look into the laws and request a copy of your policy for requirements.
Good Luck
Lee
Good Luck
Lee
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