Not again!!!! Doctors Office Mishap!

Staying positive isn't so easy for me these days, however I know that everything happens when it is supposed to.

Called the drs office today to check on my insurance submission and IT STILL HASNT BEEN SENT IT, I have been waiting 3 weeks and for some reason it just seems they are forgetting about me.

Today I have officially had enough, I told the lady that I got the exact same response last week "It will be sent off to your insurance today" and it wasn't. I wanted to know WHY and all that and they had no answers for me. The insurance lady won't return my phone calls. I left her a message that wasn't the nicest in the world. I told her if they couldn't get it submitted I could find a Drs office that could.

I know all things happen for a reason, and things happen when they are supposed to but why does it seem like i'm being neglected, i feel like they are only forgetting about "me". Has this happened to anyone else? How hard is it to send paperwork to an insurance company.

I guess i'm just upset, confused and wish this whole ordeal would just hurry up already.
I am trying my best to stay positive but right now it's very very hard and not getting any easier.

I plan to call their EVERY SINGLE DAY until I have some results. I know that may be bothersome and mean but it seems like nothing will get done otherwise.

Please everyone keep me in your prayers, I really REALLY need it.

Jordan I want you to know you are not alone it this struggle.
The waiting has got to be the worst part of wls.
One thing that helped me was I made sure I got copies of all reports from the required test.
If I were you maybe you should find out where to send your paper work and send it certified mail.
By doing it certified you will get a notice your papers had been recieved.
Always make copys of everything.
I do not understand why having to get through all the red tape is so blasted hard sometimes it really sucks big time.
Also my insurance denied me the first time and I took the bull by the horns and hand delivered my appeal along with a detailed letter about how life is for a super morbid obese person.
With in two weeks I was approved.
Keep in mind you are the consumer and you are not being mean by calling and calling.
The people who should be following through with your case I feel they may never know what life can be like for an obese person.
Hang in there and DONT YOU GIVE UP!!!
                                                                          Annie

Jordan,

       I know that it seems really hard right now and nothing is going the way you want it to go but I am asking you as a good friend, PLEASE don't give up! You have came way to far to give up now. I do know though that if all of your tests have been done, and if you do want to change dr's, my surgeon's office gets things done fast as you know. So before you even think about giving up, try his office if things don't work out. I am here for you if you need me. BTW, my cell number has been changed once again so I gotta give u my number and do not hesitate to call me. Believe me I can talk your ear off, just ask Annie..lol..

Ok well I am gonna go cause I have a big day tomorrow. I gotta go to my youngest son's picnic at the school and I got to get joshua ready for his first dance. Yes I am gonna cry like a baby...lol.. Take care Jordan.

                       Linda

See the reason I absolutely LOVE to post here is because of the wonderful support you guys always give me.

Annie-Thanks so much for taking the time to offer kindness and support
&
Emelinda-Thanks so much for all you've done for me, we just need to get together and talk sometime. Good Luck on the dance for you son and at the picnic. I saw you are down 55 pounds. That is amazing I am so PROUD of you.

Much love to you both and Thanks Again!

Hi Jordan,

I understand your frustration. I would consider asking to speak with the office manager. I know that this journey is filled with a great deal of emotion, but when you talk to them, I think it's best to try to remove the emotion from your voice. Try to list what it is you  need to have them do. Ask what the process is and where you are in the process, and what if anything you can do to facilitate moving it forward. When you talk to someone find out what the process is for submitting it to the insurance company. Is is mailed to them or submitted electronically? Ask them if they can tell you the 'normal' turn-around time for the insurer you use. They generally will know. Some turn things around very quickly, others take longer to review and respond. Generally, there is a timeframe that they insurer has to work in... it might be 72 hours or 10 business days, 30 calendar days, etc... I understand that you'd just like to get it submitted in the first place. 

Unfortunately, many times you cannot submit the information directly to the insurance company yourself. Having copies of the paperwork, tests, etc. is a good thing to do and have, so that if something is misplaced you have a ready copy to provide to the Dr's office so that they can submit it to the insurance, but in the main, the Dr's office has to submit the paperwork directly to the insurance company. Many times this is done electronically, where they send coded and scanned information to the insurance company. 

I do think that daily calls to check the status is in order. I would do so sweetly, but firmly every morning.  When they let you know that they are 'sending it in' ... either by mail, fax or electronic coding/scanning, I'd ask them how long it usually takes for the insurance company to receive it... 15 minutes? 3 days?... Once you get that information, I'd be on the phone to insurance company within that window and see if they've received it... Often there is a case manager at the insurance company that can tell you where your 'package' is as it goes through the review and determination process. Once you find out if they have received it, you can check to see if they have everything they need to make their determination. It may take them a while to determine this... it varies from company to company. It took about 10 days for them to be sure that they had all of the information they needed when mine was heading for the determination assessment. Once it hit the reviewer's desk it was just a matter of hours.

If you don't find that the package has been submitted/received as promised within 3 to 5 days, with firm, but diplomatic calls each morning, I'd be calling twice a day. Morning and evening... again, firm, but diplomatic. I might even make a polite, firm and diplomatic visit to the office to see what could be done to resolve the issue because the Dr has vested interest in processing your paperwork. Otherwise, as you've indicated you can take your marbles somewhere else, especially if you have kept copies of all of the records and paperwork. If I had to make a trip to their office, I'd probably already have the name of another office that I had consulted with to take over the surgery. I'd let them know that I need them provide proof of submission... i.e., a fax receipt, electronic transmission receipt or a postal receipt or confirmation from the insurer that the package had been submitted and/or received or I would want them to provide me copies of my complete medical record so that I could provide it to the new surgeon's office. I might even see about sending a letter to that effect to the Dr. directly before pulling the plug... As I said, he has a vested interest in making this work. While his front office may be a pain, it's really the Dr and his program that will be most important to you in the long run and if you have already researched him and feel that he will do the best job for you, I'd try contacting him via mail if polite, diplomatic phone calls and a visit to the office don't work.

I do believe that you will get your package submitted and processed.

Wishing you all the best,

 

I truly hate that this is happening to you. I know how frustrating it can be when your so anxious to start your journey.

I'm sure it doesn't help to know that Dr. Enoch's office is notorious for this all the time. You have to do their job for them by staying on top of them, calling every other day to make things happen.  Get use to it. Even after your surgery, this is the treatment you'll get. Almost every person I've met from Enoch's has this problem all the time.

Someone even posted that he doesn't even show up for the post-op appointments.

This is all about YOU. This is YOUR moment, your journey and your experience.  While you may not be the only patient, it is still only about YOU.   You deserve the best and deserve to be treated as such.

You may consider this.  You are putting yor life on a table...  at this point, are you comfortable with that where you are now?  

If you are, then do exactly what you are saying and push push push and demand.  If nothing else, your paying for a service. There are expectations.

Don't give up! I'll keep you in my prayers!

{{{{{Big hug}}}}}

Hang in there Jordan! I cannot offer anything better than the advice from Annie and Barb, and others. We have all experienced an unexplained delay in some part of the process so we do understand your frustration.

Take a deep breath and take the bull by the horn and try to keep the emotions at bay.  I believe the squeak wheel gets the oil but the mean wheel may get left on the side of the side of the road.

I remember being in medical review for 6 weeks. No explanation, the girl with no comorbidities just an extremely high BMI. Made no sense to me and I called once a week to hear the same thing. Then all of a sudden, I had to hang on for the ride cause within 3 weeks I was on the OR table.

Our shoulders are here, so keep on the office and soon it will go by in a blur. You'll be posting you got a date!

Call EVERYDAY! It does pay off. I'm sure everyone in Dr Enochs office knows my name and telephone number, but I got what I needed to get done, Done! I was scheduled for surgery on the29th and just got a call today to move it up to this week! I know it seems aweful, but they really are doing everything they can to get people through.

Yippee for Me!!

Got the call today that it was mailed to my insurance provider yesterday. Now I am finally where I need to be.

Thanks everyone for all the advice and support!