Waiting for approval

Tammi W.
on 5/30/07 1:10 pm - Westfield, MA
Hello, I've just joined this great site and want some advice from anyone who might have faced this same issue. I've gone through my medically supervised diet at a weight loss center (since early Dec), provided all necessary information - was approved by the Dr, the nutritionist and the Psychologist. My surgeon's office submitted paperwork back on 5/10/07. I had not received anything about anything and am stressing constantly about this.  So I called my ins. co - I've gone through the whole "I don't see it in the sytem' blah, blah....finally found a rep who is doing a great job keeping me informed of the slow progress at the ins co. My issue is with the staff at the surgeon's office. There's a person who submits all the info, and I've talked with her once - I've tried to call back to speak with her 2 other times, and both times was told she will 'call me back.'   It happened again today. I don't want to be pushy - but would appreciate common curtesy of a call back - anyone have similar issues - and what did you do?????
steambacker
on 5/31/07 3:29 am - Hull, MA
Hello, I'm just curious what insurance company you have?  Did the insurance company ever receive the paperwork and what did the rep tell you when you spoke to the helpful person there?
RNY surgery 05/23/07  Starting weight:  310
Right before operation: 279  Current weight:  117 Goal:  150
Tammi W.
on 5/31/07 11:34 pm - Westfield, MA
I have Cigna EPO.  I had issues with the paperwork arriving when the dr's office said it did.  The helpful person actually called my dr's office and spoke to the woman doing the paperwork and had her fax all my docs to his machine directly.  He said that they were most likely held up in the scanning dept. So - the docs are there now, and I'm just waiting for them to approve.....
steambacker
on 6/1/07 6:09 am - Hull, MA
That was so nice of that person!!!!  I think they take about 3 weeks to approve as I know someone else on this insurance.  It could be less hopefully    I hope all goes well with your operation and you get approved easily!!! Jenn
RNY surgery 05/23/07  Starting weight:  310
Right before operation: 279  Current weight:  117 Goal:  150
lindie
on 6/15/07 6:49 am
I think that the problem in that office is that the person who does the submissions also does loads of other things as well. Dr. K calls her "the boss." I've tried her a few times and found it best to call at the end of the day. She told me that she goes home at 4. It took my ins. co. (BC/BS) two weeks to respond after paperwork submission. Hope you hear something soon. Good luck.  Lindie
Tammi W.
on 6/15/07 8:43 am, edited 6/15/07 8:44 am - Westfield, MA
lindie, It appears we are in the same area, and have the same doctor - and that you know who I'm talking about. Well - it's been 24 days since the ins co. 'officially' got my paperwork, I've called the surgeon's office multiple times - and haven't talked to her at all. I've finally decided to chill and let things work out as they will - if its meant to be (and I know it is) - it will be. I see you are getting your surgery in a week or so - I wish you luck and all the best.  Are you ready?

 

lindie
on 6/15/07 11:24 am
Oh yeah, I'm more than ready.  I'd still call her again. All you want to know is if she's heard anything because it's been over three weeks. Not too much to ask. If the ins. co. needed more information, she should have no trouble telling you that. I'd give her another call and if you don't hear from her, I'd drop a note to Dr. Kasper documenting the whole ordeal. I commend your patience, but don't forget- and I hate to get businesslike- you are employing them; they are not doing you a favor. No one can change the speed of the ins. co.'s response but communication with the patient is the responsibility of the doctor's office. There is enough anxiety involved in this whole process already! Twice when I called, I got the information read off my chart to me by someone else- including my surgery date. I also had to leave a message to reschedule my pre-op testing and my pre-surg appt. and got that information from someone else when I called the next day.  Hey, I have an idea- Why I don't I call for you?????     Good luck.  Lindie
lindie
on 6/16/07 11:15 pm

Tammi,  I just learned from a friend of mine that it took a long time for her approval, too. She asked the woman in Dr. Kasper's office to show her what was faxed. Turns out that several things were missing, including the letter from the referring physician (Keroack). My friend had Dr. Keroack's office fax their paperwork to the ins co and she herself refaxed the rest. Hope this helps.  Lindie

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