I Am at a Loss

After 11 months of trying to get approval and being told no.  I tried one last time to get approval and out of the blue an approval let showed up.  I met the surgeon, scheduled the surgery, took out a loan for my deductible and copay,  rescheduled my seminars, clients  and work schedule for four weeks, my wife has adjusted her schedule, my parents thiers, not to mentions a team of Dr's and nurses.  Two days out I am told insurance Companies letter of approval was a mistake.  Good old United Healtcare.

Davo

I  am not a lawyer, but I would sew them.  You were mailed approval for payment.  I would fight this for the next 48 hours and make them pay for it.  Talk to whomever you can high up the food chain when you speak to them.  This is B.S.  Don't give up. Chris

 

Today I have talked to Ins. Co, and my employer.  United Health Care informed me that the letter of approval was sent out but the same day a dissaproval letter was sent out the same day.  Yet no one got the letter.  The surgeons office followed up with questions on billing and were told the surgery was elective and that I would owe money.  I took out a loan, rescheduled all my work,  met with the surgeon etc. etc.   I work in sales where I give seminars for financial planning and estate issues.  It my take months to set something up.  If I don't work for two weeks it affects the next three months with the potential of no income.  Now I have to somehow get work to fill in the next four weeks, fight the battle again, recoop my loan, and start all over.  My only recourse is start a legal battle.  I am so upset and sad I have a difficult time expressing the level at which I have sunk.  

I am sorry to hear this Davo. I also believe there has to be recourse for this.  Did they notify you through the mail, through the doctors office? It just sucks you have to deal with this now. Troy

Dave, That’s truly a big kick in the Nads! Sorry for you. Do keep at it…. I know, even after 11 months. There’s guys here who worked for it for 2 years… A glad to have finally made it. Tough as it is,  Don’t give up hope. Many don’t get approval until after they’ve been turned down And get it on appeal. Others not until their second appeal.  even look into a WLS Lawyer- GaryViscio his profile at- http://www.obesityhelp.com/member/gviscio/ He's the sort of "Staff Guy" here.... Should be samples of appeal letters  here too- Helpful Forms and Downloads just generally see what you can lift from- http://www.obesityhelp.com/forums/insurance/ It totally suks to have it snatched away like that, But know it is still a possibility to get back. Best Wishes- Dx

 

Davo - Yeah, that's a no lube and no reach around if I ever heard it!!!! Dx beat me to the post for Gary's info and the insurance assistance page here on OH, so scroll up and go check out those links if you haven't already. Above all, remember that things do not always go according to our own plans for a reason. We don't have to understand it and we don't have to like it, but we are obligated to keep on working towards the goal.  Ask yourself, "How bad do I want this?" If the answer is that you want it bad enough to go to any extreme necessary, then you really want it.  The harder you work to get your tool, the harder you will use it when you get it and the more you will appreciate it. DO NOT!!!!  Let me repeat that.......DO NOT just give up and roll over.  I had a hell of a fight with multiple insurance companies and even changed jobs multiple times seeking an insurance carrier that would provide me with the coverage I needed.  If I had to go back and do it all over again, I would do it all twice. Hang in there.  Go check out the links Dx gave you.  Keep fighting!!! We'll keep pulling for you and we'll be here to support you through it all.

Thanks for your support.  I am not sure of my direction but I will continue to head somewhere I guess.  It is very frustrating, time consuming and stressfull.  Getting feedback and words of encouragement are helpfull.  Thank You

The hand wringing and excuses are starting to fly.  The insurance company is standing by thier statement that the approval was a mistake.  They claim they mailed out the denial letter immediately after the opproval.  None of the medical staff recieved the denial.   Today some of the big whigs as I was told were meeting with the broker of my companies ins. plan and requested I fax a copy of the approval letter.  Which is curious as to why they did not want the denial letter that no one has.  So I complied and faxed the ins. co a copy of thier own paperwork since they do not have it.   Now I sit and wait.   It is funny I was kind of excited to see if my name showed up on the surgery dates list and now I don't want to see it there because my surgery was cancelled.    More to follow....