FINALLY!! Now about that stress....
Anyone have an idea HOW I can manage to get my surgeon's support staff to be more supportive? As far as I'm concerned, she had what she needed Monday...here it is Thursday and this puts me back another week....IF Cigna gets my file again Monday, they'll take that whole week to decide, and by the time I get a date, it'll be later this Fall. I just want this DONE.
Has anyone else been through the mill with this too??
Marie
Marie-
Consider that it IS NOT your surgeon's support staff, but the insurance company using this as a delay tactic. It is not uncommon for insurance companies to request information or say that information is missing to delay the decision. Often times, if a decision is delayed, the person doesnt fight back, especially if it happens a few times, they dont have to pay for surgery. They MAKE you jump through hoops thinking that you will give up.
Consider calling the insurance company and finding out what they are in reciept of and when they got it, and compare to what was sent from your MD office and when. You could also ask for it to be mailed with someone signing for it rather than faxing if they fax it.
You may be getting angry at the wrong person for the wrong reasons. The insurance company has much more to lose monetarily compared to your surgeons support staff.
Good luck
Norman
Hi Norman,
I understand what you're saying about the insurance industry and have heard it from other people too. In this case the staffer told me she when she sent everything. The first time she sat on things for three weeks (it was complete, because I was informed at my last required visit that it was ready to go). The staffer told me that my insurance company is difficult to deal with. Yet the case manager called me directly to alert me that she hadn't received the additional pieces from my surgeon yet. Also, the CM let me know that just because the automated line says nothing is on file doesn't mean it's true. I found out yesterday it takes up to three days to log incoming things in. I am fully aware that my insurance company might truly be a cast iron b*tch to deal with but the people I've talked to have been very nice. We'll see what happens in round two. I expected a denial the first time around so it wasn't a surprise, just a disappointment. Now I just want this over with.
Hi Marie
At the time of surgery I had Atena for insurance which is similar to Cigna in getting approvals. My surgeon knew I wanted surgery in the middle of June due to I am a teacher. The office didn't put my paper work in until sometime in July. I was not very happy. Then the letter I recieved stated they needed all the required documentation. I called the surgeon's office and the OM stated she sent everything. Well, the OM was correct it was my insurance company who was dragging their heels. They also had 45 business days to approve or deny my surgery. I was approved in about 30 days. So my surgery date did not take place until November 21 instead of the middle of June. I know it is a very long process but try to be patient your time will come. Good Luck!
Janet
Marie-
The reason I brought it up was that one of my friends had a similar insurance and she went through two denials and her doc finally had to call the insurance company and talk with the medical director, I think twice! She was so frustrated! She finally got surgery but it wasnt without the stress of dealing with the insurance company denials. I'm sorry this is adding to your stress and frustration, but I wanted you to be prepared and think that you may need to look at the process from a few different angles.
Best wishes and lots of luck
Norm
Thanks Janet...Cigna said the same thing. Dr. Hess' OM said teh file was 33 pages and she got the confirmation that they got all of it. I've been told insurance companies don't want to pay for this kind of surgery...it's understandable. I'm having issues on both ends. Hess' office and Cigna. I wnated my surgery in early June right after my daughters wedding so I'd stress less.....I'll have to breathe deep instead, because I'm still not approved yet! The OM said that she's booking his surgeries into August. That was a few weeks ago so now I'm figuring late summer, early to mid Fall. It seems most others on my local list never had the issues I am, so I'm starting to wonder if it's me!?
Marie