This is so frustrating

I am getting the run around, I have Horizon NJ Health and the Surgeon that I am dealing with is the only surgeon that I have found in New Jersey that does the Gastric Bypass Surgery, The HMO i have is through Medicaid, The surgeon's office is so busy that I am not getting a straight answer out of them, They said that they submitted my info to the Insurance co., but the insurance company says thay have nothing for me.  The doctor's office keeps telling me to call back.  I wish I knew someone at the Insurance company that can help me.  I just don't know what to think am scheduled to have the surgery July 16, 2007, if i get approved from my insurance company.  It has been 2 weeks and the Insurance company stills says they have nothing for me.  I am so frustrated, I don't know if anyone knows of another surgeon that takes my Insurance?  Help me please. Melissa

Hi Melissa, I have Horizon BC/BS and I went through Barix Clinics in Langhorne, PA.  You might want to call them to see if they take your insurance.

hi melissa what part of jersey are you in?  who is the surgeon you have now? if the insurance company says that they did not recieve your packet then you have to call the surgeon's office and tell them that the insurance company does not have it and ask them to resubmit it can you only use a dr in jersey? or can you go over the bridge into philly? good luck roberta

Hi Roberta, I spoke with my surgeon's office today and they said they will call the insurance company and see if they received my paperwork, if they didn't they will resubmit it, they told me to call back tomorrow, and they will let me know.  I will call tomorrow but I decided if My date of July 16,2007 comes and goes then I will find another surgeon, I will be patient for right now, I am tired of the frustration, but I think I need to just sit back and just pray about it, I believe there is nothing more I can do for right now, until the surgeon's office calls me and let's me know whether I have been approved or not I will wait until the July the 6th not this Friday the next friday and if I haven't heard anything about my approval by then, then I will search for another surgeon.

well good luck to you :) i'll be thinking of you  this is why i'm grateful that my surgeons office does not give a surgery date or do any testing until they are sure that they have an approval -- i found that to be to my benefit -- i wan't worried about getting everything done by a certain date -- not worried about wondering if my testing would still be current by the time the insurance company approved -- i got approved, had my testing, got my surgery date, cancelled my surgery, got another date, no worries and no problems -- just went with the flow of things as for changing surgeons -- the ones that everyone listed up in north jersey have wonderful reputations here on the board :) and as for south jersey i'm partial to my surgeon over in philly :)  Good Luck Roberta

Hi -  I have Horizon BC/BS and I had a similiar issue. My dr. office sent over all info and was supposed to have an answer in 48 hours. I waited 2 weeks and called insurance company and they said they never received my paperwork. I called dr. office and the said they sent it and after that resent it. This went on for 2 more weeks. It was nerve wracking. Dr. office had to get intouch w/ manager of insurance company, it turned into a crazy mess. I had to change my dated to a month later because was not approved in time. The dr. office was great and it was the insurance company that was trying to stall by saying it did not receive my info. Good luck -

My advice is to be persistant !!!  I too was told the FIRST time I called the ins co that  they never received my paperwork.  I immediately called the surgeon's office for an explanation.   They DID send the information !!!  So the surgeon's office called the ins co... and stated that they faxed all the information and gave them the CONFIRMATION for the fax.  So it was THEN confirmed by this phone call that all paperwork was received.   I made a follow up phone call to the ins co one week later to check on the "status of authorization for surgery"  and was told it was still in review.  TODAY which is TWO weeks from receiving the paperwork...  I received APPROVAL !!!!! KEEP CALLING.   If the surgeon's office is FAXING the info....there should be a confirmation of that. A follow up phone call to be sure they received it should also be made by the surgeon's office. I would call the ins co EVERY DAY until they tell you they have your info and are reviewing it. then give a week or so to check up on things. Good luck.....don't give up.....stand up !!!!! Regards,   Lo

You may want to call the insurance company and have them conference the surgeons office.  Then ask the surgeon to fax the information.  This is important to you, you have to make at least the isnurance company believe it is important to them as well to satisfy you as a member.

Thanks all for your responses, I did speak with the surgeons office yesterday and all they did was blow me off they said that when they sent the fax last friday the fax machine did confirm that it when through, so they have no need to call them.  I have to wait until a week before my surgery and if they haven't  heard from the insurance company, then they will call.  That means 2 weeks went by without knowing whether my paperwork was received and then my date might have to be pushed up.  I called my insurance company and they won't give me any answers, they say that the surgeons office has to call them.  This is so frustrating, all I want to know is if they received it or not. Melissa