I hate insurance problems rant and question.

So for the second time since I started this process, I am being told I am not covered. I met with Dr. Goyal and his team on Tuesday, at that time I made an appointment with their nutritionist. I verified she was "in network".
Today I get a message from the nutritionist saying she called my insurance (Aetna HMO) and was told I'm not covered for her consult, NOR am I covered for bariatric surgery! Grrrrr
Ok, so I call my insurance asap and they tell me, nooooooo, I AM covered as long as I meet the pre-cert requirements. Which is what I was told in the first place. Not only that, but the nutritionist is, in fact, covered and in my network.
I am so confused and concerned. I asked them to send me a letter indicating that I am covered, just in case. My question is this, when does the doctors office send info to the insurance company regarding pre-certification and approval? How can I ensure this doesn't happen again? Thanks all....

the only thing you can do is to nag the doctors office and the insurance company till they get their stories straight.

its sucks big time, but insurance rules the healthcare world now, not the doctors or the patients.

try and set up a conference call between aetna and your doctor, they will do that if you are persistent.  ask for a case manager from aetna, give them a hard time.  they do usually come thru in the end

be safe and well, jacki

Great advice about the conference call! I think I'll do that. Thanks Jacki!

Just as much fun -

I'm covered.  I was approved.  Aetna sent my doctor 20% of his fee.  I now have a $9000 bill - and my husband did it too - so unless the insurance company re-evaluates, we're $18,000 in the hole for this.