Question:
Need to blow off steam about my insurance company

My surgeon sent everything to my insurance quite a while ago. Insurance immediately asked for a psych evaluation and I asked them is that all you need and they said yes. So I got it and faxed it to them. They told me they still needed the PCP letter (remember I asked if they had everything!). Got that re-faxed to them (it had been sent a month ago!). Then they called me 2 days ago and said they had everything and would make a decision in 24 hours. Yesterday when I followed up, they said they had just sent a letter asking for my diet history and my after surgery care plan!!!! Can you believe this????? So I sent them a letter telling them they would receive both items by fax from my surgeon today. I explained that I needed to have the surgery in the next 4-6 weeks for work purposes and could they please RIGHT NOW, look through everything and satisfy themselves that they have EVERYTHING they need. If not, call me right away. I was very respectful and pleasant but I am hoping this letter makes them aware that they need to tell me NOW what they need. Man! I know they're not going to deny it or they would have already but I cannot keep having to send them stuff each and every day for the next 2 years. I'll probably be disabled by then.......    — Nell C. (posted on June 13, 2002)

June 13, 2002
hey Nell, I know it's hard, but you just have to hang in there. I'm not to fond of insurance companies myself, but you do have to admit, you are asking them to spend quite a bit of money on you...granted you need it, but still that's how it usually goes down. I do however want to tell you to be optimistic, it may take a while to get an answer, but you'll get one, and i'm sure it's going to be the answer you've been waiting for. Just be prepared for more run arounds, cause i'm sure they've got plenty. Also don't you think you're kind of rushing it a bit saying you need the surgery in the next 4-6 weeks. I thought it took longer than that!.. Oh well, either way, it's okay, but just remember to stay optimistic, for some reason it works. :-)
   — Laydie K.

June 13, 2002
Hi: Welcome to the world of "INSURANCE H---". I did this with my medical group for almost 5 mos and then had to threaten to start calling anyone that would be connected enough to rock their boat. I had to threaten to contact all media, state representatives, dept of corportations, you name it. Funny how those threats sometimes fall upon deaf ears, because 1 1/2 hours later, I was approved, AFTER 3 TURN DOWNS....DON'T GIVE UP!!!! Stay right on their "INSURANCE BUTTS"....they're paid by the hour to sit there and make your life miserable......don't give up....you have to much time already invested into this to go south now....I found that when I started asking for first and last names,extensions,supervisors names, corporate address name address and phone number, I got ALOT more attention. I just wanted that person working on my file, to know that I MEANT BUSINESS AND I WASN'T GOING AWAY!!!!Good Luck...p.s. 10 mos post op and down #131...
   — Joi G.

June 14, 2002
Well, I got my first denial letter today by fax. They denied me because they do not have everything they need to make a determination. Ironically, I got 2 different letters asking for 2 different sets of information. Even more ironic, all of the stuff asked for they have received at least 2-3 times each. I am putting together a notebook with a summary and numbered tabs. I am writing a cover letter itemizing each point, naming names and dates, etc. and will overnight the finished results to them. Then we'll see. The 4-6 weeks is when my doctor's office can give me a date IF I can get approval quickly........... I've been at this since November, 2001............
   — Nell C.

June 15, 2002
Well, my whining and complaining worked!!! While I was preparing a 3 inch thick indexed and summarized binder of all the information for the insurance company --- again --- they called and approved me!!! Yeah!!!!
   — Nell C.