Peer to Peer Never happened

I was suppose to have a peer to peer review with BCBS of IL and Dr Roslin today.  The review was suppose to be between the hrs of 11 a.m and 1 pm.  I had an appt with Dr Roslin at 2 pm.  When I got their I was looking to hear some type of news.  (REWIND) I was denied 3x already for the same reason.  No medical record documentation that I was compliant with diet and exercise.  On the last denial letter they decided to put Reason: Lack of Medical Necessity and suggest we have a peer to peer.  (FAST FWRD) Now everything is set and my Dr. is ready to fight for my approval and NO one calls.  (Blank Face).  I just dont get this.  Are you kiddin me?  While I was there Dr. Roslin tried calling them and he told me they were being difficult.  The further and further I go with all of this, the more and more I realize how F@#k up this system is.  Of course I went back to work extremely disappointed but not mad.  I realize it is time to contact my HR dept to speak to the HR rep.  I spoke to a very nice young lady who said she will try her best to help me.  At this point im about to send an appeal letter because this is just BS.  I was trying to wait  things out but it seem like they just want a fight. 

V

MAN- how ANNOYING! What a waste of veryone's time. Can you explain what a peer-to-peer review is, though?

Its when your surgeon and the medical director at the insurance have a phone call to discuss your case and convice them to approve.

Continue to fight, fight, fight and fight!!!!!

Frankie

Unfortunately, I had to delete this post due to privacy concerns.

Hi Shelli

I have escalate this to my HR dept and just waiting to hear back about this peer to peer review.  If this does not happen by Friday or if they deny me again im prepared to send my appeal out first thing Saturday fedex.  While waiting for that I will be contacting the state department for insurance as well.  I was doing research and found out about that as well.  I will sue the hell out of these ******** if I have too.  They truly dont know who they are messing with.  Like I said I will not accept no as an answer especially when I know I was compliant. with everything and have proof of everything.