The women in my surgeons office are IDIOTS!!
So my dads stuff was submitted to the insurance 2 weeks ago and a week later the lady that handles the insurance stuff calls and says that my dad is denied. So she says we need to start working on an appeal. She faxes over the "denial" letter-----
"OptumHealth Care Programs has been requested on behalf of your insurance cpmpany to review specific services for medical approprateness. At this time, optumhealth has either recieved no information or insufficient information to make a recommendation. The following information is needed so that optumhealth can review the requested services: Medical Records. Nutritional counseling, excercise counseling, Psychological counseling, and preeoperative counseling. We also neeed preperative medical consulatation and approval. You may write or call within 45 days. If over 45 days you must appeal."
Ok, so... where in there do you see the word DENIED??? The women told us that they are requesting that we need a 6 month supervised diet. Which pissed us off because we didnt need that in April... So what happened is that the insurance company is now using this optumhealth to review this stuff instead of them. She went on to tell us that they have changed our requirements. So today my mom calls the insurance company to see what is going on. They tell her that my dad and I arent denied.. that they just needed my thyroid levels and my dad need something else. She then tells my mom that "no, we have no changed our requirements we just changed the reviewer in May."
You know, I try to be patient with people and I have been really nice to everyone in the surgeons office. But everytime I call her she is SOO rude to me and has such a attitude. Shes not like that with my mom.. Just me. And I am sooo nice to her! I dont understand it. So anyways.. she f*cked up. now she is going to have to fix this. Honestly... Im considering switching surgeons. Its a hassle because there arent any surgeons that do this near us and we ave to drive 4 hours to another state. If I do switch I was told that I will have to meet the surgeon and almost have to start over... So I guess im stuck.. All I know is.. I just want the damn surgery! Ive jumped through enough hoops and ive waited long enough!
Sorry.. thanks for letting me vent. And sorry its long! lol
Your surgeon's office sounds screwey...What do other patients from that practice have to say here on OH...you can always come to Phoenix - there's quite a few docs here, and I think the surgeon that I have been going to for follow-up care is reallyl, really good, and probably quick too. I'm pretty good buds with someone who works there if you'd like I could ask how long the process would be for someone who already has current labs etc...
For the most part I like the surgeons office. I know there are nicer places and probably better Doctors around but ive come this far I really dont want to start all over or almost all over. I thought about going to Phoenix, but after living there last year I really dont want to go back till December sometime.. lol. Its too hott! But more than that, it is still 8 hours away and I cant afford to be driving there or flying. My mom had her surgery with the same surgeon last month and she loved it. She said the hospital staff was great, clean, and comfortable. Its just the office women we are having problems with. They just always seem to have a attitude when we call or they dont know what they are doing. I called a different doctors office in the same city and they told me that I would have to call the old place and have them transfer everything and I would have to make an appointment with the doctor before he will even decide to do my surgery. Im going to play it by ear and see what happens within the next 2-3 weeks. If I dont see a change I will switch doctors. Thanks for the help and encouragement!