I was lied to by my doctor or by my Insurance

I called to ask my BlueCare/Medicaid provider for another list of doctors who does the surgery. They asked me why? I said I have been approve to have the surgery. My PCP office called and told me months ago. I have been on a waiting list that stop taking my Insurance. I was then informed that they show no records of me being approved for the surgery. They did not receive any of the referrals that was suppose to be sent. They then told me to have my doctor resubmit the referrals. And if he can not find a doctor call back and they will find one. I do not know which one is lying. I just know I am having one heck of a time trying to get this surgery. I just hope it happens before I turn 80. I would like to know, Do you have to pay for TennCare/Medicaid? I do not know about my insurance My mother and My brother picked the plan for the entire family. Now I am in the dark mostly. It is weird I am 28 yrs.old and I do not know much about state insurances.But I am learning real fast. Well this will teach me a good lesson. Thanks, Tina

Tina, you have to start listening, all you need to do is call the service number on the back of your card and tell them you want a case manager assigned to you. That will be the only person you will have todeal with. The case manager will help you find a surgeon who accepts medicade. The Dr.'s (surgeon's office is who deals with the insurance) and no you don't pay for medicade, it's thru the state. I have medicade and I haven't had to deal with them. I leave that up to my surgeon's office. Try calling the customer service number on the back on your card. Trust me I have been at this for 2 years. And I haven't had to deal with the insurance one bit. After you call the customer service number it may take 1-2 days, in the mean time, start calling the surgeons in the area. Colquitt/Ray are south of knoxville here's their number 865-9843413. Dr. Michael Hodge and Watson are east of here in Johnson City, Dr. Digby in Elizabethton is just outside of Johnson City. Hodge and Watson charge $200 up front and that's it. Digby charges $100 up front. They deal with the insurance to get you approved. You have to have all your medical records, a letter of medical necessity from PCP, and any other Dr. you see. So don't fret that someone is lying, do the above and save yourself a lot of aggrivation. Always, Kathy

I'm with Kathy on this one Tina Good luck and please keep us posted ML

Remember you don't send them to the insurance, good way for them to be lost. After you get your records and letters, get a surgeon. His office faxes your records to the insurance and they get a form back when and what time they were received by Medicade. The only thing you do with the insurance is get a case manager, and ask Medicade if they cover bariatric bypass surgery. They do by the way, But may not come January. So you need to find a surgeon who will accept it and get that ball rolling. Your records never leave your surgeons office unless you change surgeons. All files and referrals are faxed to your insurance. You just have to find the surgeon and get a case manager to help you. Hold on to your records. By the way, most Dr.'s will charge around $20 for a copy of your records. Good luck, Kathy PS I have tried to email u back but your filter system won't accept emails from me. Sorry.