Insurance Case Manager?

reggi_67
on 8/7/08 1:00 pm - Florence, AZ
RNY on 09/19/14
Hi all...
I had a message left on my phone from an Insurance Case Manager? Am I being paronoid... is this the procedure for them to follow when they deny my surgery approval? My information was just submitted 7/28/08 and I am thinking that something is being questioned. Does everybody get assigned a Case Manager?
Deanne K.
on 8/7/08 2:11 pm - Tucson, AZ
They could be following you for other health issues.   I have had a case manager to deal with asthma and general health issues and she asked me what my general health issues were and I was upfront and told her that I needed to get the weight off and she called back about 3 weeks later and was asking about the appeal and how I was doing..  She was the one of the instruments of me finally getting my denial letter, the lawyer at this point was also sucessful in getting the letter.  She went to her supervisor and got me a letter sent out., certifed mail   It was over 30 days and I hadn't received it.  It was UHC.  Don't be afraid to call them.
Lori G.
on 8/8/08 3:04 am - Phoenix, AZ
Almost all Health Plans have Case Managers to review request for authorizations.  No need to worry as they are the ones who are gathering the information to help them make the decision of acceptance or denial.  They usually are a good contact and can assist you with the process as necessary to meet the medical criteria that the Helth Plan has set.

Lori G., BS, RN-C, CBN
Certified Bariatric Nurse & Service Line Coordinator
Certified Obesity Help Support Group Leader
Bariatric Clinical Educator for Paradise Valley Hospital 
602-923-5612  [email protected]                                       
RNYGB 8/2003 (maintained 170# weight loss)

L. TP
on 8/8/08 7:55 am
Yes they called me too.  I totally avoided them. I didn't want anything to cost me my surgery.  Its paranoia maybe but I wasn't taking any chances.  After several messages from them I made it a point to call after hours and just thanked them for their care and calls and told them that the hospital already has a manager set up for me specifically and that I will contact them in the future if I need helped and thanked them again.  I never heard from them again.


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