Frustrated and need right words to express to Dr

Started in Dec wanting a revision with Dr. Anthone. They informed me they would submit to insurance for approval afer the first of the year because I have new insurance.
Called them towards the end of Jan to see if they submitted; they submitted to the wrong insurance.
Called again in Feb, they submitted but not all the info went to insurance so it was back and forth with them submitting more information.
Finally Feb 15th they denied everything because they did not submitt all/correct information.
-Revision was denied because they claimed I was not complient wiht taking Vitamins; No where does my records say I was not taking vitaimins. But it does say I was only taking multi vitamin.
-Hernia denied because they did not submit the size of the hernia and it repairing it will fix the issue?
-Pani removal denied because it does not state how long I have had it, being over a 3 month period. I wrote a letter that the Dr office requested stating that I have had it over 10 years.

Now the insurance compancy stated that they had 2 weeks from denial to resubmit without going into an appeal. Did they do this NO.
Called almost every week or week 1/2 to see if they have submitted anything yet.....NO
What do I have to say to the Dr office to get there butt into gear and get this submitted and correctly so it gets approved.....At the point where I want to leave an go to another surgeon or submit the information to the insurance myself.....
What to say? what to say?

Well, if it was ME being treated like this, I would be emailing the surgeon directly: [email protected].  And I would be telling him EXACTLY how sloppy, careless and cavalier his office staff is being with matters that affect your LIFE.

But then I'm assertive/*****y that way.

Well I sent off my email to Dr.Anthone yesterday afternoon. Now to wait on a reply...Hope it is not as long as the phone calls have been hehe
Thanks for the words

Keep fighting!!!  Always HOOPS!!!!  I personally have been at this over 2 years, and we (me & doc's office) are SOOOOOO close to re-submitting again, for the 3rd time, with insurance..... 




Keep up the good fight!!!!
-Jamie

Ok so last week I sent this to the doctor;
I am writing you in regards to my case. I have been in contact with your office over the past 4 months in regards to have a revision, hernia repair and panni removal.
We first met back in December for our consult. After the consult I spoke with the office staff about submitting approval to insurance right after the first of the year due to insurance company change. I then again contacted the office mid January to see how things where going, they informed me that they submitted to insurance, but they submitted to the incorrect insurance company.

Once things where corrected and insurance was sent the needed information, in February. I was contacted a few times for multiple information or other paper work that the insurance company needed which should have already been in my file.

I received the denial letter from insurance, which was very interesting on why they denied the procedures. From what I gathered is that they were just sent papers rather than a summary of my information.

I contacted the insurance and they informed me why items were denied and that your office had 2 weeks to submit the needed information without having to go back into appeal. I informed your office of this.

It now has been a month since the denial letter and still no word on if anything was resubmitted to insurance. If there is any information that is needed from me I will gladly give this to get the process moving again.

Really hoping to have surgery by mid April but the longer we wait to get approval from insurance I know you will be scheduling surgery's well into the summer months which might be an issue with my family and there schedules.
TO ONLY GET A REPLY FROM THE SEC 3 DAYS LATER;
Just wanted to send you a message regarding an update.  I believe Dr. Anthone is working on an appeal letter for your insurance company.  He will have that dictated and ready to send over to transcription.  Transcription is running behind a week but as soon as it is done I will be forwarding it to your insurance company.
STILL NO WORD THIS WEEK SO SEND THIS BACK TODAY
It is now 1 1/2 months since I have heard we are going to send in an appeal letter. Also going on 5 months since we started this whole process.
Please give a firm update and know if information has been submitted to insurance for approval.
I am about 2 weeks away from going to another surgeon, which will be greatly disappointing since I want Mr. Anthone to do my surgery.
AND GET THIS REPLY, NOT SURE I SHOULD BE MAD OR JUST WAIT THE WAITING GAME?
I do apologize as Christy and I have been in the meeting madness that occurs in March.  I have reminded Dr. Anthone and Christy has reminded Dr. Anthone regarding the case.  We have done a peer to peer conversation and the Dr. for Aetna stated that it is not documented medically in her file then it was not a conservative method of treatment and must have been easily to controlled with over the counter methods.  Dr. Anthone has been trying to overcome this obstacle.  
        I do understand the frustration, and I promise we are tending to the issue at hand, but I also understand if you would like to seek other avenues regarding the surgery.   I will ask him today again after he is done with his emergency case.  
NOT SURE I BELIEVE HER?

So, I am not sure when his emergency case is over, but, if I were you, I wpuld play the "squeky wheel" and call daily, just so you know what is going on!!!




Good LUCK!!!  I have been at this over 2 years!!!!
-Jamie