Question:
I don't know what to do. I was denied with BCBS/PPO cos they needed
a Psych eval. letter. Doctor's office has faxed it twice. Insurance company says they have never received it. Been over and over with the insurance company on the fax number, etc. What do I do? They say they don't have it. Doctor's office says they faxed it twice. To the fax number the insurance company says. WHAT DO I DO NOW? — Judy W. (posted on April 2, 2002)
April 2, 2002
I would go to the doctor's office and pick up a copy of the psych eval
letter. I would then mail it to the insurance company and send it certified
or registered with signature guarantee so someone has to sign for it.
— blank first name B.
April 2, 2002
If you have access to a fax, get a copy of the psych eval. Then call the
insurance company. Get the name of the person you're talking to and the
fax number they want. Tell them you are sending it immediately and for
them to call you back if they don't get it in 10 minutes. If you can
actually send the fax while you're on the phone so much the better.
— garw
April 2, 2002
Hi. I had the same problem with BCBS but this was with the info sent fromt
he surgeon (request letter, etc). The doc's office sent it to them twice.
Finally the angel at my doc's office kept the woman on the phone while she
faxxed it and did not hang up with her until the woman said she had it in
her hand. That may be what you have to do. BCBS looks for any excuse to not
pay for this operation. After being denied I finally got approved all b/c
of a stupid code. Make sure your surgeon also is using the code for MORBID
obesity. Without the word "morbid" they don't deem you worthy
enough for it I guess :( Good luck!
— Renee V.
April 2, 2002
Interesting how experiences differ....I have BCBS PPO and I was not
required to have a psych evaluation, and my surgery was approved over the
phone on the day of my first consult with my surgeon....I was on the
schedule for surgery two weeks later....
— Cathy J.
April 2, 2002
The old "lost the fax routine". I would get a copy of it myself.
Call the person to whom you need to fax it, to get their fax number and
tell them you will be faxing it over, write a cover letter in great big
print, attn their name. Fax it and then call about 15 minutes later. If
they didn't get it, fax it again and call in about 15 minutes. Repeat until
they admit they have it in their hand. Persistance pays and BC/BS is one of
the worst for pulling the old "didn't recieve the fax" tricks in
order to put you off.
— Dell H.
April 2, 2002
Have to jump in with my standard insurance info. Insurance companies are
often different from one state to another and from one employer to another.
Don't just assume that because BC/BS, or Aetna or Cigna pays in one state
that it pays everywhere, OR that because it doesn't pay in one state it
won't pay anywhere. And, even within the same state, an employer can vary
the basic policy so that's it's different from any other employer.
— garw
April 2, 2002
I sent all my paper-work FedEx,over night delivery, requiring a signature.
I was dealing with BCBS/PPO and got the same run around also. Call and get
the specific name of the person who you are sending the information to and
a street address. Mark the airbill URGENT!!!to get their attention as soon
as it is delivered. This will cost about $15.00 but it is a small price
to pay considering the results you will get. I am sure UPS and Express
Delivery from the Post Office would have the same effect. Good luck!
— Janet M.
April 2, 2002
I have BC/BS PPO of Georgia. I have been going thru drama as well. My
surgeons office sent the LOMN out on the 20th. I got my copy on the 23rd
which was a Saturday. That following Monday I called to make sure they got
it, they said they had no record. They gave me a fax# I could fax it too.
My dr.'s office faxed it. I called the 25th to see if they got it - still
no. The customer service person told me that when faxes come in one person
comes around once a day to pick then up and logs them in within two days.
Ok so I called back on the 28th still nothing.April 3rd, I called AGAIN
gave them the fax# that we had been faxing to and she tells me that its the
wrong one, that's a bad number. WHAT - Im like why didn't someone tell me
before now, she was like I don't know but use this new fax #. So I called
my Dr.;s office and left them a message to fax it this morning. I'll call
again Friday to check on it. I guess the main thing is to be persistant and
cover all your bases
— mikawill
April 11, 2002
Similar situation. Insurance says never received authorization request
from Dr. So,I got a copy of it called blue cross (BC of CA) and asked for
the name and fax # of the person I need to send it to. Called the next
morning to confirm they received it. They did. I even sent an additional
fax of why the surgery was important to me (at 1 o'clock in the morning).
I also requested they call me to confirm this person received the fax. I
requested they call me prior to calling my physician with approval info,
they did. The approval came in 3 days. So, talk to the same person every
time, even if you have to leave a message for them to call you back. Be
persistent but be nice! No one breaks their back to help a rude person,
right??? OH, and keep good tracking notes of who, when, what...
— Kim M.
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